DIRECCION ADMINISTRATIVA ANEXO VII Cuotas (pesos) · Nota: Los precios de los servicios y/o...

Nota: Los precios de los servicios y/o tramites del 2008 aun son vigentes para el año 2013

SSY DIRECCION ADMINISTRATIVA ANEXO VII

Cuotas de productos que se autorizan para el Tabulador de Servicios Médico-Asistenciales 2008-2013

Cuotas (pesos)

1 de 25 TAB 2008 AUTORIZ APBPY 08

6.00 10.00 16.00 30.00 53.00 63.60 11.00 20.00 35.00 64.00 106.00 127.20 10.00 15.00 28.00 50.00 89.00 106.80 13.00 25.00 42.00 68.00 110.00 132.00 11.00 20.00 35.00 64.00 106.00 127.20 10.00 15.00 28.00 50.00 89.00 106.80 15.00 33.00 60.00 110.00 166.00 199.20 0.00 0.00 0.00 0.00 0.00 0.00 8.00 14.00 25.00 45.00 71.00 85.20

16.00 34.00 60.00 102.00 160.00 192.00 8.00 14.00 28.00 53.00 89.00 106.80

28.00 52.00 92.00 161.00 258.00 309.60 40.00 78.00 140.00 248.00 386.00 463.20 60.00 113.00 204.00 368.00 578.00 693.60

131.00 368.00 696.00 985.00 1,313.00 1,575.60 126.00 242.00 427.00 751.00 1,202.00 1,442.40 102.00 192.00 352.00 643.00 1,031.00 1,237.20 97.00 186.00 328.00 581.00 922.00 1,106.40 97.00 186.00 328.00 581.00 922.00 1,106.40

152.00 300.00 519.00 905.00 1,445.00 1,734.00 34.00 66.00 122.00 222.00 352.00 422.40

135.00 271.00 460.00 781.00 1,208.00 1,449.60 11.00 20.00 35.00 64.00 106.00 127.20 78.00 169.00 281.00 465.00 704.00 844.80 86.00 164.00 283.00 486.00 769.00 922.80

112.00 214.00 372.00 643.00 1,016.00 1,219.20 137.00 260.00 449.00 776.00 1,232.00 1,478.40 54.00 102.00 181.00 323.00 523.00 627.60 40.00 78.00 140.00 248.00 401.00 481.20 40.00 78.00 139.00 246.00 397.00 476.40

126.00 246.00 422.00 726.00 1,139.00 1,366.80 188.00 360.00 627.00 1,091.00 1,743.00 2,091.60 83.00 160.00 268.00 451.00 703.00 843.60 86.00 164.00 283.00 486.00 769.00 922.80 50.00 96.00 169.00 299.00 479.00 574.80

39.00 72.00 129.00 229.00 381.00 457.20 225.00 390.00 790.00 1,466.00 2,424.00 2,908.80 211.00 414.00 736.00 1,345.00 2,224.00 2,668.80 333.00 668.00 1,187.00 2,146.00 3,499.00 4,198.80 349.00 693.00 1,217.00 2,188.00 3,569.00 4,282.80

6.00 13.00 21.00 37.00 58.00 69.60 25.00 31.00 38.00 50.00 63.00 75.60 76.00 94.00 113.00 151.00 189.00 226.80

176.00 220.00 265.00 265.00 441.00 529.20 151.00 189.00 227.00 302.00 378.00 453.60

54.00 106.00 205.00 399.00 638.00 765.60 6.00 13.00 21.00 37.00 53.00 63.60 6.00 10.00 15.00 26.00 43.00 51.60 6.00 10.00 15.00 26.00 42.00 50.40 6.00 10.00 15.00 26.00 43.00 51.60 6.00 11.00 18.00 29.00 45.00 54.00 6.00 11.00 18.00 29.00 45.00 54.00 0.00 0.00 0.00 0.00 0.00 0.00

16.00 33.00 60.00 112.00 181.00 217.20 23.00 43.00 78.00 144.00 218.00 261.60 37.00 71.00 131.00 243.00 382.00 458.40 37.00 71.00 127.00 231.00 368.00 441.60 37.00 71.00 127.00 231.00 368.00 441.60 37.00 71.00 127.00 231.00 368.00 441.60 72.00 140.00 256.00 472.00 721.00 865.20 47.00 84.00 154.00 276.00 454.00 544.80

Clave Descripción Nivel

Exento Nivel 1 Nivel 2 Nivel 3 Nivel 4 Nivel 5 Nivel 6 Nivel 7

010-00 Consulta externa

010-01 Consulta general 0.00 4.00

010-02 Consulta especialidad 0.00 6.00

010-03 Consulta subsecuente de especialidad 0.00 5.00

010-04 Consulta extemporánea 0.00 6.00

010-05 Consulta urgencias 0.00 6.00

010-06 Observación de 2 a 12 hrs. 0.00 5.00

010-07 Observación de 12 a 23 hrs. 0.00 10.00

010-08 Hidratación oral 0.00 0.00

010-09 Hidratación de menores 0.00 5.00

010-10 Hospitalización día cama 0.00 10.00

010-11 Día incubadora 0.00 4.00

020-00 Cirugía general (mayor, interna y menor)

020-01 Lipomas 0.00 14.00

020-02 Quiste cereceo quirúrgico 0.00 23.00

020-03 Fimosis 0.00 33.00

020-04 Extirpación ganglionar 0.00 26.00

020-05 Mastectomia 0.00 67.00

020-06 Hernia umbilical y paraumbilical 0.00 55.00

020-07 Hernia inguinal 0.00 53.00

020-08 Hernia crural 0.00 53.00

020-09 Hernia hiatal 0.00 83.00

020-10 Quiste pilonidal 0.00 18.00

020-11 Apendicectomia 0.00 73.00

020-12 Extracción de uñas 0.00 5.00

020-13 Litotomía 0.00 40.00

020-14 Safenectomía por extremidad 0.00 45.00

020-15 Eventración postquirúrgica 0.00 60.00

020-16 Histerectomía, anterectomia y biopsia 0.00 73.00

020-17 Extirpación de tumores de piel malignos 0.00 28.00

020-18 Extirpación de tumores de piel benignos 0.00 21.00

020-19 Fisuras 0.00 21.00

020-20 Tiroidectomia 0.00 66.00

020-21 Frenorrafia 0.00 96.00

020-22 Coledocorrafia 0.00 42.00

020-23 Diastasis de rectos 0.00 45.00

020-24 Sello de agua 0.00 25.00

021-00 Paq. de Cirugía menor corta estancia sin uso de quirófano.

021-01 Lipomas, nuevos quistes 0.00 19.00

021-02 Hernia umbilical 0.00 131.00

021-03 Hernia inguinal 0.00 123.00

021-04 Hernia hiatal 0.00 195.00

021-05 Apendicectomía 0.00 205.00

030-00 Odontología

030-01 Consulta y plan de tratamiento 0.00 5.00

030-06 Apicoformación 0.00 19.00

030-07 Corona de acero cromo 0.00 57.00

030-08 Mantenedores de espacio 0.00 132.00

030-09 Sedación 0.00 113.00

031-00 Operatoria

031-01 Atención por cuadrante 0.00 28.00

031-02 Obturación con amalgama de plata 0.00 4.00

031-03 Obturación con resina compuesta 0.00 4.00

031-04 Obturación con IRM o con óxido de zinc 0.00 4.00

031-05 Restauración con corona de acero de cromo 0.00 4.00

031-06 Restauración con corona de celuloide 0.00 5.00

031-07 Cemento incrustaciones y corona 0.00 5.00

031-08 Aplicación de flúor 0.00 0.00

031-09 Exodoncia simple (por pieza) vía alveolar 0.00 10.00

031-10 Exodoncia múltiple con regularización 0.00 11.00

031-11 Exodoncia por disección 0.00 20.00

031-12 Cirugía preprotésica 0.00 20.00

031-13 Cirugía periapical 0.00 20.00

031-14 Cirugía parodontal 0.00 20.00

031-15 Cirugía ATM prótesis 0.00 38.00

031-16 Reducción cerrada de fractura mandibular 0.00 23.00




Cuotas (pesos)




031-17 Reducción abierta de fractura mandibular 0.00 49.00 97.00 186.00 324.00 562.00 888.00 1,065.60

031-18 Mandíbula 0.00 194.00 365.00 703.00 929.00 1,223.00 3,577.00 4,292.40

031-19 Maxilar 0.00 194.00 365.00 703.00 929.00 1,223.00 3,577.00 4,292.40

031-20 Bimaxilar 0.00 389.00 731.00 1,405.00 1,855.00 2,447.00 7,152.00 8,582.40

031-21 Pulido de restauración 0.00 5.00 6.00 11.00 20.00 35.00 53.00 63.60

031-22 Cirugía de labio fisurado 0.00 26.00 53.00 102.00 176.00 304.00 481.00 577.20

031-23 Cirugía de paladar fisurado 0.00 26.00 53.00 102.00 176.00 304.00 481.00 577.20

031-24 Drenaje de abceso en quirófano 0.00 20.00 39.00 76.00 135.00 241.00 379.00 454.80

031-25 Drenaje de absceso en consulta externa 0.00 10.00 18.00 35.00 64.00 116.00 180.00 216.00

031-26 Excisión de neoplastia bucal c/anest. local 0.00 39.00 73.00 141.00 256.00 462.00 743.00 891.60

031-27 Excisión de neoplastia bucal c/anest. gral. 0.00 47.00 92.00 171.00 306.00 552.00 883.00 1,059.60

031-28 Excisión de neopl. bucal r. x. periap. y oclusal 0.00 4.00 5.00 6.00 13.00 23.00 45.00 54.00

031-29 Curaciones dentales 0.00 4.00 6.00 13.00 21.00 37.00 53.00 63.60

031-30 Limpieza cabitron 0.00 5.00 10.00 16.00 30.00 54.00 89.00 106.80

031-31 Suturas dentales 0.00 10.00 18.00 34.00 62.00 112.00 181.00 217.20

031-32 Odontoxesis 0.00 6.00 11.00 23.00 39.00 71.00 108.00 129.60

031-33 Silicato 0.00 4.00 6.00 10.00 15.00 26.00 43.00 51.60

031-34 Dientes supernumerarios 0.00 20.00 37.00 72.00 131.00 241.00 382.00 458.40

031-35 Mùltiples bajo anestecia 0.00 20.00 37.00 72.00 131.00 241.00 382.00 458.40

031-36 Extracción tercer molar 0.00 20.00 37.00 72.00 131.00 241.00 382.00 458.40

031-37 Obturación con ionómero de vidrio 0.00 4.00 19.00 53.00 100.00 137.00 189.00 226.80

032-00 Terapia pulpar

032-01 Recubrimientos pulpares 0.00 3.00 4.00 5.00 10.00 18.00 28.00 33.60

032-02 Pulpotomía piezas posteriores 0.00 3.00 5.00 5.00 10.00 20.00 39.00 46.80

032-03 Pulpotomía piezas anteriores 0.00 4.00 5.00 6.00 13.00 23.00 45.00 54.00

032-04 Urgencia pulpar 0.00 57.00 76.00 94.00 113.00 151.00 189.00 226.80

033-00 Radiologìa

033-01 Técnica oclusal 0.00 3.00 5.00 10.00 16.00 29.00 49.00 58.80

033-02 Técnica periapical 0.00 4.00 5.00 5.00 10.00 16.00 33.00 39.60

034-00 Patología dental

034-01 Profilaxis 0.00 5.00 8.00 13.00 23.00 43.00 78.00 93.60

035-00 Cirugía

035-01 Frenivectomia 0.00 12.00 61.00 170.00 322.00 455.00 607.00 728.40

035-02 Ostiomielitis 0.00 5.00 8.00 13.00 23.00 43.00 71.00 85.20

035-03 Parodoncia 0.00 5.00 6.00 13.00 21.00 38.00 53.00 63.60

035-04 Gingivectomia 0.00 6.00 10.00 20.00 35.00 62.00 93.00 111.60

035-05 Plastia labial 0.00 8.00 42.00 119.00 225.00 318.00 424.00 508.80

035-06 Endodoncia 0.00 11.00 23.00 43.00 78.00 141.00 218.00 261.60

035-07 Distractor dactilar y mandibular 0.00 62.00 108.00 197.00 513.00 1,337.00 1,968.00 2,361.60

036-00 Plastias gingivales hiperplastias

036-01 Pordifenhidantoina cuadrante 0.00 5.00 6.00 13.00 21.00 38.00 58.00 69.60

036-02 Debridación y canalización de abscesos 0.00 4.00 5.00 6.00 11.00 20.00 37.00 44.40

036-03 Corrección de fistula oro-angral 0.00 4.00 6.00 10.00 16.00 30.00 58.00 69.60

036-04 Apicectomia 0.00 5.00 10.00 16.00 30.00 58.00 93.00 111.60

036-05 Bloqueos liticos a nivel trigeminal 0.00 4.00 5.00 10.00 16.00 30.00 52.00 62.40

036-06 Regularizacion de proc. alveolares residuales 0.00 4.00 5.00 6.00 11.00 20.00 38.00 45.60

036-07 Tulvidina y toma de biopsia 0.00 4.00 5.00 6.00 11.00 21.00 38.00 45.60

037-00 Traumatología

037-01 Suturas menores 0.00 4.00 6.00 13.00 23.00 43.00 76.00 91.20

037-02 Fractura dentoalveolar férula aparte 0.00 8.00 14.00 26.00 49.00 91.00 160.00 192.00

037-03 Fractura mandibular estable 0.00 8.00 14.00 26.00 49.00 91.00 161.00 193.20

037-04 Fractura mandibular inestable y fer. (osteo.) 0.00 11.00 20.00 35.00 66.00 125.00 218.00 261.60

037-05 Fractura tercio medio gigométrico malar 0.00 5.00 9.00 15.00 29.00 54.00 93.00 111.60

037-06 Suturas mayores (10 puntos) 0.00 5.00 10.00 18.00 35.00 67.00 110.00 132.00

038-00 Exodoncia

038-01 Implante normal (por pieza) 0.00 5.00 8.00 13.00 23.00 43.00 67.00 80.40

038-02 Implante anormal (por pieza) 0.00 6.00 10.00 18.00 35.00 64.00 101.00 121.20

038-03 Órganos dentarios retenidos (por pieza) 0.00 6.00 13.00 28.00 52.00 98.00 144.00 172.80

039-00 Ortodoncia

039-01 Cuota por sesión 0.00 5.00 10.00 16.00 30.00 58.00 93.00 111.60

040-00 Salud mental

040-01 Pruebas de personalidad 0.00 14.00 25.00 48.00 87.00 163.00 271.00 325.20

040-02 Pruebas vocacionales 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

040-03 Pruebas psicométricas (individual) 0.00 35.00 66.00 127.00 222.00 386.00 602.00 722.40

040-04 Paquete de pruebas psicom. (más de 5 p) c/u 0.00 18.00 34.00 64.00 112.00 193.00 304.00 364.80

040-05 Pruebas mmpi 0.00 8.00 14.00 23.00 45.00 87.00 139.00 166.80




Cuotas (pesos)




040-06 Pruebas de wais 0.00 8.00 13.00 28.00 49.00 89.00 141.00 169.20

040-07 Pruebas de tat 0.00 8.00 13.00 25.00 48.00 89.00 139.00 166.80

040-08 Pruebas de buck 0.00 6.00 13.00 26.00 47.00 78.00 118.00 141.60

040-09 Pruebas de bender 0.00 5.00 9.00 18.00 33.00 58.00 84.00 100.80

040-10 Pruebas de habitat 0.00 5.00 9.00 16.00 29.00 52.00 83.00 99.60

040-11 Pruebas de wipsi 0.00 8.00 13.00 28.00 50.00 91.00 137.00 164.40

040-12 Pruebas de wisc 0.00 8.00 13.00 28.00 50.00 91.00 137.00 164.40

040-13 Terapia conyugal (por pareja de 1 a 3 sesiones) 0.00 5.00 6.00 13.00 21.00 35.00 53.00 63.60

040-14 Terapia familiar (familia de 1 a 3 sesiones) 0.00 5.00 6.00 13.00 21.00 35.00 54.00 64.80

040-15 Terapia individual (de 1 a 3 sesiones) 0.00 4.00 6.00 10.00 16.00 30.00 53.00 63.60

040-16 Terapia de grupo de 1 a 3 sesiones por persona 0.00 4.00 6.00 13.00 23.00 39.00 54.00 64.80

040-17 Hospitalización psiquiátrica por día 0.00 8.00 13.00 25.00 47.00 87.00 131.00 157.20

040-18 Hospitalización psiquiátrica mensual 0.00 231.00 426.00 819.00 1,100.00 1,472.00 3,959.00 4,750.80

040-19 Desintoxicación alcohólica 0.00 38.00 74.00 144.00 253.00 442.00 679.00 814.80

040-20 Prueba de Roscharch 0.00 5.00 9.00 18.00 33.00 58.00 84.00 100.80

040-21 Inscripción a grupos de orientación (anual) 0.00 11.00 21.00 37.00 50.00 91.00 164.00 196.80

040-22 Grupos de orientación (mensualidad) 0.00 11.00 14.00 16.00 18.00 33.00 59.00 70.80

040-23 Paseos terapéuticos 0.00 11.00 21.00 37.00 50.00 91.00 164.00 196.80

050-00 Dermatología

050-01 Biopsia 0.00 8.00 14.00 29.00 52.00 93.00 147.00 176.40

050-02 Electrodesecaciön 0.00 10.00 18.00 34.00 62.00 112.00 181.00 217.20

050-03 Electrofulguración 0.00 10.00 18.00 35.00 64.00 115.00 181.00 217.20

050-04 Crioterapia 0.00 6.00 13.00 23.00 43.00 78.00 131.00 157.20

050-05 Extirpación de verrugas 0.00 8.00 14.00 28.00 52.00 97.00 166.00 199.20

050-06 Extirpación de lunares 0.00 10.00 20.00 37.00 67.00 123.00 202.00 242.40

050-07 Estudios mocológicos 0.00 5.00 6.00 13.00 21.00 38.00 59.00 70.80

050-08 Rasurados 0.00 13.00 24.00 45.00 83.00 155.00 236.00 283.20

050-09 Criocirugía 0.00 8.00 14.00 29.00 53.00 100.00 163.00 195.60

050-10 Radioterapia superficial 0.00 8.00 14.00 29.00 53.00 100.00 163.00 195.60

050-11 Peeling químico superficial o medio 0.00 20.00 37.00 71.00 127.00 228.00 365.00 438.00

050-12 Aplicación tópica 0.00 11.00 23.00 43.00 78.00 142.00 215.00 258.00

050-13 Aplicacion intralesionar 0.00 15.00 29.00 58.00 105.00 192.00 289.00 346.80

061-00 Estudios

061-01 Estudio audiofoniatrico completo 0.00 9.00 15.00 33.00 58.00 98.00 155.00 186.00

061-02 Estudio audiométrico básico 0.00 6.00 10.00 20.00 34.00 59.00 89.00 106.80

061-03 Estudio audiométrico complementario 0.00 5.00 8.00 13.00 21.00 38.00 66.00 79.20

061-04 Estudio foniátrico 0.00 6.00 10.00 20.00 34.00 59.00 89.00 106.80

061-05 Colocación de aae 0.00 4.00 6.00 11.00 18.00 34.00 53.00 63.60

061-06 Estudio afasiológico 0.00 11.00 23.00 43.00 74.00 126.00 197.00 236.40

061-07 Estroboscopia 0.00 11.00 23.00 43.00 74.00 126.00 197.00 236.40

062-00 Terapias de rehabilitación

062-01 20 Sesiones al mes (5 por semana) 0.00 25.00 49.00 96.00 160.00 292.00 475.00 570.00


062-03 8 Sesiones al mes(2 por semana) 0.00 15.00 30.00 53.00 98.00 185.00 315.00 378.00


062-05 1 Sesión 0.00 5.00 9.00 15.00 28.00 49.00 81.00 97.20

070-00 Medicina física y rehabilitación

070-01 Sesión de terapia física 0.00 5.00 6.00 13.00 21.00 37.00 54.00 64.80

070-02 Sesión terapia ocupacional 0.00 5.00 8.00 13.00 21.00 39.00 67.00 80.40

070-03 Sesión terapia psicológica 0.00 4.00 5.00 10.00 16.00 33.00 50.00 60.00

070-06 Cardiometria por impedancia 0.00 10.00 15.00 34.00 60.00 105.00 161.00 193.20

070-07 Valoración cardiaca por paquete: p/ esfuerzo 0.00 35.00 62.00 118.00 209.00 363.00 561.00 673.20

070-08 Monitoreo de control cardiaco 0.00 14.00 25.00 53.00 96.00 165.00 258.00 309.60

070-09 Terapia del lenguaje 0.00 6.00 8.00 16.00 30.00 53.00 84.00 100.80

080-00 Gineco-obstetricia

080-01 Histerectomía abdominal 0.00 58.00 108.00 204.00 359.00 631.00 1,017.00 1,220.40

080-02 Histerectomía vaginal 0.00 64.00 118.00 224.00 399.00 711.00 1,145.00 1,374.00

080-03 Bartholinectomía 0.00 28.00 49.00 92.00 166.00 305.00 500.00 600.00

080-04 Conificación 0.00 29.00 58.00 106.00 188.00 331.00 539.00 646.80

080-05 Resección alta o baja de cérvix 0.00 28.00 55.00 106.00 186.00 328.00 525.00 630.00

080-06 Debridación de absceso mamario 0.00 18.00 37.00 66.00 117.00 213.00 348.00 417.60

080-07 Colpoperinografia (cirugía p/correc. est. pelv.) 0.00 53.00 101.00 181.00 341.00 639.00 1,104.00 1,324.80

080-08 Reseccion de quistes y tumores benignos 0.00 66.00 123.00 231.00 411.00 726.00 1,182.00 1,418.40

080-09 Drenaje de fondo de saco 0.00 24.00 48.00 89.00 154.00 267.00 420.00 504.00

080-10 Reparación de fístulas vésico vaginales 0.00 21.00 40.00 78.00 142.00 262.00 440.00 528.00

080-11 Excéresis de nodulo mamario 0.00 23.00 47.00 87.00 154.00 272.00 428.00 513.60




Cuotas (pesos)




080-12 Extirpación de polipo cervical 0.00 28.00 53.00 100.00 181.00 335.00 549.00 658.80

080-13 Laparoscopia 0.00 29.00 59.00 111.00 193.00 339.00 549.00 658.80

080-14 Salpingoclasia 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

080-15 Salpingo oferectomía 0.00 29.00 67.00 127.00 202.00 318.00 480.00 576.00

080-16 Parto distocico 0.00 45.00 89.00 189.00 350.00 645.00 1,009.00 1,210.80

080-17 Embarazo extrauterino 0.00 48.00 87.00 155.00 277.00 498.00 819.00 982.80

080-18 Parto normal 0.00 54.00 100.00 199.00 350.00 611.00 960.00 1,152.00

080-19 Cesárea 0.00 77.00 150.00 290.00 504.00 878.00 1,394.00 1,672.80

080-20 Legrado 0.00 50.00 93.00 175.00 310.00 548.00 877.00 1,052.40

080-21 Extirpación de quiste de ovario 0.00 53.00 101.00 192.00 330.00 567.00 903.00 1,083.60

080-22 Traqueloplastía 0.00 160.00 319.00 711.00 1,116.00 1,523.00 2,031.00 2,437.20

080-23 Cerclaje de cérvix 0.00 160.00 319.00 711.00 1,116.00 1,523.00 2,031.00 2,437.20

080-24 Conización de cérvix 0.00 160.00 319.00 711.00 1,116.00 1,523.00 2,031.00 2,437.20

080-25 Cirugía abdominal no clasificada 0.00 639.00 1,278.00 2,843.00 4,469.00 6,092.00 8,124.00 9,748.80

080-26 Miomectomía 0.00 319.00 639.00 1,421.00 2,234.00 3,048.00 4,061.00 4,873.20

080-27 Tumoraciones anexiales 0.00 319.00 639.00 1,421.00 2,234.00 3,048.00 4,061.00 4,873.20

080-28 Plastía tubaria 0.00 639.00 1,278.00 2,843.00 4,469.00 6,092.00 8,124.00 9,748.80

080-29 Biopsia de glándula mamaria 0.00 160.00 319.00 711.00 1,116.00 1,523.00 2,031.00 2,437.20

080-30 Metroplastía 0.00 479.00 958.00 2,132.00 3,352.00 4,570.00 6,092.00 7,310.40

080-31 Cirugía menor dentro de quirófano 0.00 79.00 160.00 355.00 558.00 761.00 1,016.00 1,219.20

080-32 Laparotomía exploradora 0.00 319.00 639.00 1,421.00 2,234.00 3,048.00 4,061.00 4,873.20

080-33 Inseminación artificial 0.00 64.00 127.00 285.00 447.00 611.00 813.00 975.60

080-34 Addaire 0.00 160.00 319.00 711.00 1,116.00 1,523.00 2,031.00 2,437.20

080-35 Cesárea-histerectomía 0.00 639.00 1,278.00 2,843.00 4,469.00 6,092.00 8,124.00 9,748.80

080-36 Colpoclisis 0.00 160.00 319.00 711.00 1,116.00 1,523.00 2,031.00 2,437.20

080-37 Cuadrantectomía 0.00 319.00 639.00 1,421.00 2,234.00 3,048.00 4,061.00 4,873.20

080-38 Extirpación de lipoma 0.00 79.00 160.00 355.00 558.00 761.00 1,016.00 1,219.20

080-39 Extirpación quiste gardner 0.00 79.00 160.00 355.00 558.00 761.00 1,016.00 1,219.20

080-40 Extirpación pólipo cervical 0.00 79.00 160.00 355.00 558.00 761.00 1,016.00 1,219.20

080-41 Hernioplastía 0.00 160.00 319.00 711.00 1,116.00 1,523.00 2,031.00 2,437.20

080-42 Histeroscopía 0.00 160.00 319.00 711.00 1,116.00 1,523.00 2,031.00 2,437.20

080-43 Histerotomía 0.00 160.00 319.00 711.00 1,116.00 1,523.00 2,031.00 2,437.20

080-44 Histeroctomía radical o amplificada 0.00 799.00 1,596.00 3,553.00 5,586.00 7,615.00 10,153.00 12,183.60

080-45 Mastectomía radical 0.00 639.00 1,278.00 2,843.00 4,469.00 6,092.00 8,124.00 9,748.80

080-46 Plastia de pared 0.00 160.00 319.00 711.00 1,116.00 1,523.00 2,031.00 2,437.20

080-47 Reparación de fístula recto-vaginal 0.00 160.00 319.00 711.00 1,116.00 1,523.00 2,031.00 2,437.20

080-48 Salpingo-ovariolisis y adherenciolisis 0.00 319.00 639.00 1,421.00 2,234.00 3,048.00 4,061.00 4,873.20

080-49 Salpingectomía 0.00 160.00 319.00 711.00 1,116.00 1,523.00 2,031.00 2,437.20

080-50 Suspensión de cúpula vaginal 0.00 160.00 319.00 711.00 1,116.00 1,523.00 2,031.00 2,437.20

080-51 Uretropexia 0.00 160.00 319.00 711.00 1,116.00 1,523.00 2,031.00 2,437.20

080-52 Servicio de transfusión fetal 0.00 33.00 64.00 142.00 224.00 305.00 406.00 487.20

080-53 Servicio de monitorización fetal anteparto 0.00 20.00 38.00 86.00 135.00 184.00 243.00 291.60

080-54 Amniocéntesis 0.00 33.00 64.00 142.00 224.00 305.00 406.00 487.20

080-55 Capacitación espermática 0.00 9.00 15.00 35.00 55.00 76.00 102.00 122.40

080-56 Fotodensitometría radiológica 0.00 213.00 297.00 564.00 814.00 1,060.00 1,356.00 1,627.20

080-57 Cariotipo en sangre periférica 0.00 64.00 127.00 285.00 447.00 611.00 813.00 975.60

080-58 Cromatina sexual 0.00 20.00 40.00 89.00 140.00 192.00 255.00 306.00

080-59 Cultivo líquido amniótico y tejidos 0.00 213.00 297.00 564.00 814.00 1,060.00 1,356.00 1,627.20

080-60 Cryocirugía cérvix uterino 0.00 67.00 134.00 297.00 466.00 636.00 847.00 1,016.40

080-61 Asa diatérmica 0.00 92.00 185.00 415.00 653.00 890.00 1,186.00 1,423.20

080-62 Mastografía 0.00 24.00 48.00 106.00 168.00 228.00 305.00 366.00

081-00 Paquetes de Gineco-obstetricia

081-01 Paq. traqueloplastía 0.00 262.00 497.00 1,041.00 1,721.00 2,633.00 3,811.00 4,573.20

081-02 Paq. bartholinectomía o marzupialización 0.00 125.00 219.00 402.00 737.00 1,361.00 2,192.00 2,630.40

081-03 Paq. himenectomia o aplicación de introito 0.00 177.00 316.00 584.00 1,078.00 2,004.00 3,260.00 3,912.00

081-04 Paq. polipectomía 0.00 177.00 316.00 584.00 1,078.00 2,004.00 3,260.00 3,912.00

081-05 Paq. cono cervical 0.00 300.00 564.00 1,177.00 1,964.00 3,069.00 4,505.00 5,406.00

081-06 Paq. vaporización de cérvix con láser 0.00 126.00 226.00 418.00 758.00 1,374.00 2,209.00 2,650.80

081-07 Paq. cerclaje 0.00 147.00 268.00 492.00 920.00 1,713.00 2,770.00 3,324.00

081-08 Paq. legrado obstétrico 0.00 199.00 354.00 671.00 1,213.00 2,189.00 3,508.00 4,209.60

081-09 Paq. legrado hemostático biopsia 0.00 199.00 354.00 671.00 1,213.00 2,189.00 3,508.00 4,209.60

081-10 Paq. senequiolisis con aplicación de D.I.U. 0.00 199.00 354.00 671.00 1,213.00 2,189.00 3,508.00 4,209.60

081-11 Paq. extracción de D.I.U. bajo anestesia 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

081-12 Paq. laparoscopía diagnóstica 0.00 158.00 283.00 539.00 971.00 1,754.00 2,807.00 3,368.40

081-13 Paq. O.T.B. de intervalo 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

081-14 Paq. biopsia abierta de mama 0.00 132.00 237.00 438.00 793.00 1,438.00 2,315.00 2,778.00




Cuotas (pesos)




081-15 Paq. biopsia de piel 0.00 71.00 142.00 265.00 452.00 784.00 1,243.00 1,491.60

081-16 Paq. biopsia de ganglios 0.00 86.00 149.00 291.00 528.00 959.00 1,546.00 1,855.20

081-17 Paq. resección de mamas supernumerarias 0.00 132.00 237.00 438.00 793.00 1,438.00 2,315.00 2,778.00

081-18 Paq. extirpación de condilomas vulv. o vag. 0.00 132.00 237.00 438.00 793.00 1,438.00 2,315.00 2,778.00

081-19 Paq. inseminación gift-fivte 0.00 799.00 1,596.00 3,553.00 5,586.00 7,615.00 10,153.00 12,183.60

081-20 Paq. parto normal 0.00 152.00 262.00 503.00 903.00 1,630.00 2,610.00 3,132.00

081-21 Paq. parto distócico 0.00 143.00 251.00 493.00 903.00 1,664.00 2,659.00 3,190.80

081-22 Paq. cesárea 0.00 216.00 384.00 725.00 1,308.00 2,357.00 3,801.00 4,561.20

081-23 Paq. histerectomía abdominal 0.00 183.00 317.00 595.00 1,084.00 1,963.00 3,176.00 3,811.20

081-24 Paq. histerectomía vaginal 0.00 181.00 313.00 587.00 1,072.00 1,943.00 3,135.00 3,762.00

081-25 Paq. colpoperineoplastía 0.00 178.00 310.00 572.00 1,066.00 1,971.00 3,263.00 3,915.60

081-26 Estudio colposcópico 0.00 2.00 8.00 22.00 41.00 58.00 78.00 93.60

090-00 Neurología y neurocirugía

090-01 Punción lumbar 0.00 13.00 26.00 48.00 86.00 156.00 253.00 303.60

090-02 Craneotomía 0.00 102.00 199.00 382.00 677.00 1,197.00 1,891.00 2,269.20

090-03 Creniectomía 0.00 77.00 150.00 289.00 504.00 883.00 1,421.00 1,705.20

090-04 Exploración de nervio periférico. plastias 0.00 48.00 92.00 176.00 315.00 558.00 883.00 1,059.60

090-05 Meningoplastia 0.00 63.00 123.00 236.00 422.00 761.00 1,192.00 1,430.40

090-06 Colocación de válvula pudens (con sonda) 0.00 156.00 302.00 588.00 1,041.00 1,842.00 2,924.00 3,508.80

090-08 tratamiento quirurgico de epilepsia 0.00 84.00 165.00 306.00 546.00 973.00 1,569.00 1,882.80

090-09 Abordaje de columna cervical vía anterior 0.00 102.00 199.00 382.00 677.00 1,197.00 1,891.00 2,269.20

090-10 Cirugía transfenoidal 0.00 102.00 199.00 382.00 677.00 1,197.00 1,891.00 2,269.20

090-13 Electroencefalografía 0.00 13.00 21.00 47.00 83.00 149.00 231.00 277.20

090-14 Electromiografía 0.00 11.00 23.00 42.00 74.00 129.00 209.00 250.80

090-15 Potenciales evocados 0.00 10.00 20.00 39.00 71.00 123.00 189.00 226.80

090-16 Neurocirugía con rayo láser 0.00 174.00 335.00 648.00 1,145.00 2,030.00 3,218.00 3,861.60

090-17 Velocidad de conducción 0.00 8.00 15.00 29.00 52.00 92.00 142.00 170.40

090-18 Mapeo cerebral con potenciales o beg. 0.00 20.00 37.00 72.00 129.00 231.00 365.00 438.00

090-19 Resección meningional frontal 0.00 37.00 184.00 515.00 975.00 1,380.00 1,840.00 2,208.00

090-20 Resección tercer ventrículo 0.00 184.00 921.00 2,578.00 4,879.00 6,904.00 9,206.00 11,047.20

100-00 Neumología

100-01 Punción transtorácica 0.00 11.00 21.00 43.00 77.00 135.00 213.00 255.60

100-02 Toracotomía 0.00 66.00 126.00 242.00 426.00 742.00 1,205.00 1,446.00

100-03 Toracotomía con resección 0.00 74.00 139.00 267.00 472.00 837.00 1,372.00 1,646.40

100-05 Toractomía de proceso mediastinal 0.00 77.00 146.00 278.00 498.00 885.00 1,454.00 1,744.80

100-06 Decorticación pulmonar 0.00 93.00 185.00 355.00 605.00 1,028.00 1,598.00 1,917.60

100-08 Mioplastia 0.00 115.00 222.00 422.00 726.00 1,249.00 1,962.00 2,354.40

100-09 Toracoplastia 0.00 72.00 116.00 268.00 451.00 757.00 1,181.00 1,417.20

100-10 Pleurotomía 0.00 50.00 100.00 192.00 315.00 515.00 789.00 946.80

100-12 Mediastinotomía 0.00 59.00 113.00 218.00 359.00 593.00 922.00 1,106.40

100-13 traqueostomia 0.00 23.00 48.00 86.00 169.00 330.00 576.00 691.20

100-14 Broncoscopía con brocoscopio rígido diagnost. 0.00 10.00 20.00 38.00 67.00 116.00 184.00 220.80

100-15 Broncoscopía con brocoscopio lavado terap. 0.00 10.00 20.00 38.00 67.00 116.00 184.00 220.80

100-16 Fibrobroncoscopía cepillado lavado biopsia 0.00 10.00 20.00 38.00 66.00 115.00 180.00 216.00

100-17 Fibrobroncoscopía biopsia transbronquial 0.00 10.00 20.00 38.00 66.00 112.00 180.00 216.00

100-18 Fibrobroncoscopía lavado broncoalveolar 0.00 9.00 18.00 33.00 58.00 98.00 154.00 184.80

100-19 Fibrobroncoscopía cepillado selectivo 0.00 10.00 20.00 38.00 66.00 115.00 180.00 216.00

100-20 Fibrobroncoscopía biopsia punción transbron. 0.00 9.00 16.00 33.00 58.00 100.00 155.00 186.00

100-21 Fibroncoscopía extracción de cuerpo extraño 0.00 13.00 28.00 50.00 89.00 159.00 258.00 309.60

100-22 Toracoscopía toma de biopsia o muest. de liq. 0.00 10.00 20.00 37.00 64.00 113.00 181.00 217.20

100-23 Laringoscopía directa e indirecta 0.00 10.00 18.00 37.00 64.00 113.00 179.00 214.80

100-24 Pruebas funcionales pulmonares y respiratorias 0.00 5.00 10.00 16.00 30.00 58.00 93.00 111.60

100-26 Pletismografía 0.00 20.00 37.00 71.00 127.00 231.00 368.00 441.60

110-00 Cirugía plástica y reconstructiva

110-01 Ritidectomía 0.00 179.00 326.00 629.00 793.00 998.00 3,232.00 3,878.40

110-02 Fasiotomía 0.00 59.00 113.00 222.00 360.00 588.00 908.00 1,089.60

110-03 Mamas de reducción 0.00 190.00 364.00 701.00 1,211.00 2,095.00 3,290.00 3,948.00

110-04 Mamas en aumento 0.00 252.00 467.00 897.00 1,310.00 1,913.00 4,751.00 5,701.20

110-05 Lipectomia abdominal 0.00 169.00 306.00 591.00 1,070.00 1,935.00 3,153.00 3,783.60

110-06 Blefaroplastía 0.00 277.00 556.00 1,067.00 1,609.00 2,433.00 5,544.00 6,652.80

110-07 Otoplastía 0.00 83.00 151.00 289.00 530.00 977.00 1,625.00 1,950.00

110-08 Mentoplastía 0.00 209.00 379.00 731.00 1,016.00 1,411.00 3,903.00 4,683.60

110-09 Progmatismo 0.00 92.00 168.00 323.00 590.00 1,079.00 1,775.00 2,130.00

110-10 Dermoabración (peeling) 0.00 147.00 271.00 517.00 931.00 1,675.00 2,746.00 3,295.20

110-11 Liposucción 0.00 255.00 467.00 897.00 1,329.00 1,967.00 4,843.00 5,811.60

110-12 Colocación de expansores 0.00 83.00 150.00 289.00 533.00 988.00 1,641.00 1,969.20




Cuotas (pesos)




110-13 Maxilofacial 0.00 105.00 208.00 399.00 711.00 1,265.00 2,063.00 2,475.60

110-14 Colgajos Miocutáneos 0.00 67.00 135.00 253.00 486.00 932.00 1,598.00 1,917.60

110-15 Colgajos 0.00 42.00 83.00 154.00 292.00 561.00 915.00 1,098.00

110-16 Microcirugía 0.00 83.00 150.00 289.00 528.00 966.00 1,610.00 1,932.00

110-17 Temorrafías 0.00 35.00 68.00 130.00 231.00 413.00 656.00 787.20

110-18 Neurorrafías 0.00 28.00 54.00 102.00 181.00 323.00 514.00 616.80

110-19 Procesos combinados 0.00 55.00 101.00 194.00 364.00 680.00 1,101.00 1,321.20

110-20 Labio leporino y paladar endido 0.00 26.00 50.00 96.00 164.00 281.00 445.00 534.00

110-21 Mastopexia 0.00 159.00 296.00 571.00 731.00 934.00 3,124.00 3,748.80

110-22 Plastia umbilical 0.00 35.00 60.00 113.00 194.00 331.00 518.00 621.60

110-23 Injertos de piel menores 0.00 17.00 84.00 236.00 447.00 633.00 844.00 1,012.80

110-24 Injertos de piel mayores 0.00 84.00 165.00 319.00 567.00 1,012.00 1,625.00 1,950.00

110-25 Cicatrices de manos 0.00 21.00 38.00 76.00 135.00 243.00 394.00 472.80

110-26 Cicatrices mayores 0.00 30.00 60.00 116.00 210.00 378.00 602.00 722.40

110-27 Plastia local (cicatrices mayores) 0.00 30.00 60.00 116.00 210.00 378.00 602.00 722.40

110-28 Prótesis de mamas 0.00 252.00 467.00 897.00 1,310.00 1,913.00 4,751.00 5,701.20

110-29 Obturador l. p. h. 0.00 149.00 174.00 253.00 343.00 467.00 602.00 722.40

120-00 Cirugía cardiovascular

120-01 Aplicación marcapaso temporal 0.00 25.00 45.00 87.00 154.00 272.00 423.00 507.60

120-02 Aplicación marcapaso definitivo 0.00 59.00 111.00 214.00 375.00 658.00 1,039.00 1,246.80

120-03 Coronariografía 0.00 26.00 49.00 92.00 161.00 284.00 449.00 538.80

120-04 Coronarioplastia 0.00 103.00 197.00 357.00 631.00 1,120.00 1,798.00 2,157.60

120-05 Trombolosis coronaria 0.00 102.00 197.00 357.00 631.00 1,120.00 1,798.00 2,157.60

120-06 Plastia de valv. pulm. aorticamitral 0.00 88.00 161.00 302.00 551.00 1,002.00 1,583.00 1,899.60

120-07 Estudio electrofisiológico (aas de. hu) 0.00 25.00 50.00 96.00 166.00 291.00 451.00 541.20

120-08 Apexcardiograma 0.00 13.00 26.00 48.00 84.00 149.00 239.00 286.80

120-09 Cateterismo cardiaco simple 0.00 37.00 66.00 125.00 218.00 381.00 595.00 714.00

120-10 Cateterismo cardiaco con angiografía 0.00 47.00 81.00 159.00 276.00 483.00 748.00 897.60

120-11 Angiografia de vasos perifericos 0.00 25.00 74.00 96.00 166.00 291.00 451.00 541.20

120-12 Ecocardiograma simple 0.00 13.00 24.00 43.00 76.00 134.00 212.00 254.40

120-13 Ecocardiograma con dopler 0.00 20.00 42.00 79.00 139.00 241.00 375.00 450.00

120-14 Electrocardiograma en reposo 0.00 6.00 11.00 18.00 34.00 64.00 111.00 133.20

120-15 Electrocardiograma de esfuerzo 0.00 10.00 15.00 33.00 60.00 112.00 174.00 208.80

120-16 Fonocardiograma 0.00 11.00 20.00 39.00 71.00 125.00 197.00 236.40

120-17 Corazón abierto 0.00 190.00 340.00 653.00 854.00 1,119.00 3,433.00 4,119.60

120-18 Corazón cerrado y grandes vasos 0.00 169.00 309.00 593.00 750.00 942.00 3,122.00 3,746.40

120-19 Aorta abdominal 0.00 97.00 171.00 325.00 581.00 1,042.00 1,623.00 1,947.60

120-20 Prueba de esfuerzo 0.00 10.00 15.00 34.00 60.00 108.00 165.00 198.00

120-21 Cirugía vascular de abdomen y tórax 0.00 123.00 226.00 432.00 780.00 1,402.00 2,308.00 2,769.60

120-22 Simpatectomía 0.00 63.00 111.00 213.00 387.00 699.00 1,091.00 1,309.20

120-23 Cirugía vascular periférica 0.00 68.00 135.00 258.00 428.00 711.00 1,091.00 1,309.20

120-24 Derivación atrioventricular 0.00 68.00 135.00 258.00 428.00 711.00 1,091.00 1,309.20

120-25 Anillos vasculares 0.00 416.00 554.00 693.00 832.00 1,109.00 1,386.00 1,663.20

130-00 Oftalmología

130-01 Cataratas 0.00 49.00 92.00 178.00 301.00 508.00 806.00 967.20

130-02 Estrabismo 0.00 21.00 107.00 300.00 567.00 802.00 1,070.00 1,284.00

130-03 Pterigion y pinguecula 0.00 34.00 64.00 122.00 224.00 415.00 689.00 826.80

130-04 Retina 0.00 66.00 126.00 242.00 418.00 726.00 1,167.00 1,400.40

130-05 Chalazión 0.00 21.00 38.00 74.00 135.00 247.00 403.00 483.60

130-06 Dacrioscistectomia 0.00 38.00 74.00 139.00 255.00 467.00 752.00 902.40

130-07 Entropión y ectoprión (y quemadura) 0.00 38.00 74.00 139.00 255.00 467.00 752.00 902.40

130-08 Extracción de cuerpos extraños 0.00 13.00 23.00 43.00 79.00 146.00 236.00 283.20

130-09 Glaucoma 0.00 54.00 110.00 213.00 367.00 630.00 1,004.00 1,204.80

130-10 Graduación de lentes 0.00 6.00 10.00 18.00 34.00 64.00 110.00 132.00

130-11 Fotocoagulación (rayo lasser) 0.00 14.00 26.00 50.00 98.00 190.00 338.00 405.60

130-12 Sondeo 0.00 5.00 10.00 16.00 33.00 59.00 102.00 122.40

130-13 Electronestacnografía 0.00 15.00 30.00 59.00 112.00 213.00 378.00 453.60

130-14 Ajustes de armazón de lentes 0.00 8.00 14.00 30.00 58.00 108.00 175.00 210.00

130-15 Fluorangiografía 0.00 16.00 33.00 63.00 113.00 205.00 338.00 405.60

130-16 Trasplante de córnea 0.00 121.00 220.00 420.00 800.00 1,518.00 2,507.00 3,008.40

130-17 Reconstrucción palpebral 0.00 38.00 74.00 139.00 255.00 467.00 752.00 902.40

130-18 Prótesis oculares 0.00 25.00 123.00 343.00 650.00 919.00 1,226.00 1,471.20

140-00 Otorrinolaringología

140-01 Extracción de cuerpos extraños en quirófano 0.00 33.00 66.00 122.00 228.00 428.00 704.00 844.80

140-02 Extracción de cuerpos extr. sin tec. quirúrgicas 0.00 5.00 11.00 20.00 35.00 64.00 106.00 127.20

140-03 Audiometría tonal logoaudiometría impedanciom 0.00 8.00 15.00 33.00 60.00 110.00 175.00 210.00




Cuotas (pesos)




140-04 Electronistangnografía 0.00 9.00 16.00 34.00 60.00 108.00 174.00 208.80

140-05 Pareséntesis del timpano 0.00 13.00 24.00 45.00 83.00 154.00 262.00 314.40

140-06 Colocación del tubo de ventilación 0.00 28.00 66.00 100.00 189.00 355.00 614.00 736.80

140-07 Timpanotomía exploradora 0.00 34.00 67.00 122.00 227.00 423.00 694.00 832.80

140-08 Miringoplastía 0.00 52.00 98.00 188.00 328.00 575.00 930.00 1,116.00

140-09 Timpanoplastía 0.00 38.00 73.00 134.00 256.00 493.00 849.00 1,018.80

140-10 Mastoidectomía simple 0.00 55.00 108.00 197.00 367.00 688.00 1,159.00 1,390.80

140-11 Mastoidectomía con timpanoplastía 0.00 81.00 159.00 287.00 508.00 900.00 1,462.00 1,754.40

140-12 Tratamiento quirúrgico de parálisis facial 0.00 83.00 150.00 289.00 525.00 956.00 1,569.00 1,882.80

140-13 Mastoidectomía radical 0.00 62.00 105.00 194.00 349.00 625.00 1,016.00 1,219.20

140-14 Estapedectomía 0.00 37.00 66.00 127.00 242.00 461.00 766.00 919.20

140-15 Laberintectomía 0.00 50.00 89.00 174.00 321.00 593.00 971.00 1,165.20

140-16 Tratamiento quirúrgico de tumores m. de oído 0.00 63.00 115.00 222.00 420.00 799.00 1,362.00 1,634.40

140-17 Tratamiento quirúrgico de tumores b.de oído 0.00 49.00 86.00 155.00 299.00 571.00 964.00 1,156.80

140-18 Tratamiento quirúrgico de absceso otogeno

endocraneano

140-19 Tratamiento quirúrgico estenosis del conduct.

auditiv. ext.

140-20 Tratamiento quirúrgico malformaciones

congénitas

0.00 53.00 105.00 198.00 389.00 769.00 1,337.00

0.00 50.00 89.00 174.00 321.00 593.00 971.00

0.00 50.00 89.00 174.00 321.00 593.00 937.00

1,604.40

1,165.20

1,124.40

140-21 Cirugía de polipos nasales 0.00 49.00 92.00 178.00 287.00 462.00 713.00 855.60

140-22 Ligadura trans-antral de la arteria max. int. 0.00 42.00 76.00 146.00 262.00 472.00 769.00 922.80

140-23 Ligadura de carótida externa 0.00 42.00 76.00 146.00 262.00 472.00 769.00 922.80

140-24 Debridación de hematoma y/o absceso sep. nas 0.00 25.00 49.00 96.00 175.00 323.00 532.00 638.40

140-25 Tratamiento quirúrgico de sequias 0.00 34.00 58.00 106.00 197.00 363.00 620.00 744.00

140-26 Tratamiento de fractura nasal 0.00 16.00 35.00 66.00 117.00 209.00 340.00 408.00

140-27 Tratamiento quirúrgico atresia coanal 0.00 71.00 127.00 246.00 451.00 832.00 1,377.00 1,652.40

140-28 Corrección quirúrgico septum nasal 0.00 43.00 83.00 156.00 275.00 479.00 756.00 907.20

140-29 Rinoplastía 0.00 239.00 479.00 920.00 1,473.00 2,357.00 5,690.00 6,828.00

140-30 Rinoseptumplastía 0.00 103.00 204.00 394.00 711.00 1,279.00 2,059.00 2,470.80

140-31 Tratamiento quirúrgico de perforaciones dent. 0.00 79.00 152.00 292.00 513.00 897.00 1,439.00 1,726.80

140-32 Extirpación de tumores benignos en fosas nasal 0.00 33.00 60.00 116.00 212.00 382.00 620.00 744.00

140-33 Tratamiento quirúrgico de angiofibroma nasfar 0.00 58.00 106.00 203.00 374.00 693.00 1,143.00 1,371.60

140-34 Tratamiento quirúrgico de sinusitis front.y/o et. 0.00 68.00 127.00 246.00 430.00 752.00 1,216.00 1,459.20

140-35 Tratamiento quirúrgico de sinusitis maxilar

(caldwell luc)

0.00 38.00 74.00 141.00 239.00 407.00 645.00 774.00

140-36 Tratamiento quirúrgico del laberinto etmoidal 0.00 59.00 110.00 212.00 372.00 649.00 1,050.00 1,260.00

140-37 Maxilectomía 0.00 43.00 217.00 607.00 1,149.00 1,625.00 2,167.00 2,600.40

140-38 Amigdalectomía con o sin adenoidectomía 0.00 33.00 63.00 118.00 222.00 404.00 658.00 789.60

140-39 Debridación de abscesos faringoamigdalinos 0.00 29.00 62.00 106.00 188.00 331.00 530.00 636.00

140-40 Tratamiento quirúrgico de ranula 0.00 50.00 89.00 174.00 323.00 600.00 980.00 1,176.00

140-41 Extirpación de glándula submaxilar 0.00 58.00 106.00 203.00 374.00 693.00 1,143.00 1,371.60

140-42 Oclusión de fistula oroantral 0.00 21.00 38.00 76.00 139.00 252.00 394.00 472.80

140-43 Taponamiento nasal 0.00 10.00 18.00 34.00 62.00 113.00 190.00 228.00

140-44 Laringofisura 0.00 33.00 60.00 116.00 210.00 378.00 614.00 736.80

140-45 Tratamiento quirúrgico de la parálisis de los abd. 0.00 71.00 127.00 246.00 451.00 832.00 1,377.00 1,652.40

140-46 Laringostomía (resoluciones de las est.lar.) 0.00 71.00 127.00 246.00 451.00 832.00 1,377.00 1,652.40

140-47 Laringectomía total 0.00 55.00 275.00 771.00 1,459.00 2,065.00 2,753.00 3,303.60

140-48 Laringectomías parciales 0.00 71.00 127.00 246.00 451.00 832.00 1,377.00 1,652.40

140-49 Procedimientos reconstructivos (colgajos lar) 0.00 33.00 60.00 116.00 210.00 378.00 607.00 728.40

140-50 Tratamiento quirúrgico de remanentes embrionar 0.00 71.00 127.00 246.00 451.00 832.00 1,377.00 1,652.40

140-51 Laringoscopia dir. expl. microscopia de laringe 0.00 15.00 73.00 204.00 386.00 547.00 729.00 874.80

140-52 Obturadores por maxilectomía 0.00 71.00 127.00 246.00 451.00 832.00 1,377.00 1,652.40

140-53 Rinectomía prótesis nasal 0.00 16.00 35.00 66.00 117.00 209.00 340.00 408.00

141-00 Paquetes de otorrinolaringología

141-01 Extracción de c/extraño nasal 0.00 41.00 80.00 150.00 280.00 528.00 873.00 1,047.60

141-02 Cirugía polipos nasales 0.00 65.00 118.00 226.00 371.00 622.00 990.00 1,188.00

141-03 Tratamiento de fractura nasal 0.00 34.00 63.00 117.00 212.00 388.00 651.00 781.20

141-04 C. qx. septum nasal 0.00 75.00 135.00 256.00 459.00 817.00 1,320.00 1,584.00

141-05 Rinoseptumplastía 0.00 138.00 260.00 499.00 905.00 1,635.00 2,656.00 3,187.20

141-06 Sinusitis maxilar cadwel 0.00 78.00 138.00 267.00 469.00 831.00 1,361.00 1,633.20

141-07 Amigdalectomía con o sin adenoidectomía. 0.00 92.00 155.00 301.00 554.00 1,018.00 1,711.00 2,053.20

150-00 Urología

150-01 Nefrectomía 0.00 91.00 171.00 328.00 578.00 1,017.00 1,648.00 1,977.60

150-02 Pielilotomía 0.00 77.00 146.00 281.00 491.00 859.00 1,391.00 1,669.20

150-03 Cistostomía 0.00 48.00 93.00 176.00 350.00 692.00 1,198.00 1,437.60




Cuotas (pesos)




150-04 Prostatectomía 0.00 77.00 146.00 281.00 512.00 930.00 1,520.00 1,824.00

150-05 Corrección de reflujo vesicouretral 0.00 68.00 130.00 247.00 430.00 748.00 1,202.00 1,442.40

150-06 Dilatación uretral 0.00 25.00 52.00 93.00 180.00 353.00 593.00 711.60

150-07 Punción de absceso prostático 0.00 21.00 39.00 76.00 141.00 266.00 426.00 511.20

150-08 Orquiectomía 0.00 18.00 92.00 256.00 485.00 687.00 916.00 1,099.20

150-09 Meatotomías 0.00 25.00 50.00 93.00 180.00 349.00 582.00 698.40

150-10 Diálisis peritoneal (con equipo) 0.00 88.00 178.00 339.00 616.00 1,123.00 1,819.00 2,182.80

150-11 Diálisis peritoneal (sin equipo) 0.00 67.00 130.00 253.00 460.00 830.00 1,348.00 1,617.60

150-12 Hemodiálisis (con equipo) 0.00 43.00 78.00 151.00 285.00 530.00 883.00 1,059.60

150-13 Hemodiálisis 0.00 5.00 10.00 16.00 33.00 63.00 111.00 133.20

150-14 Extirpación de tumores retroperitoneales 0.00 56.00 278.00 778.00 1,473.00 2,085.00 2,780.00 3,336.00

150-15 Extirpación de tumores renales 0.00 60.00 113.00 218.00 374.00 644.00 1,042.00 1,250.40

150-16 Biopsia renal percutanea 0.00 36.00 180.00 504.00 954.00 1,350.00 1,800.00 2,160.00

150-17 Trasplante renal 0.00 1,228.00 2,454.00 4,721.00 5,713.00 6,912.00 28,329.00 33,994.80

150-18 Litotripsia 0.00 1,535.00 3,068.00 5,902.00 5,902.00 5,902.00 35,410.00 42,492.00

150-19 Colocación de catéter blando 0.00 88.00 178.00 339.00 673.00 1,329.00 1,819.00 2,182.80

150-20 Colocación de catéter para hemodiálisis 0.00 43.00 78.00 151.00 285.00 530.00 883.00 1,059.60

150-21 Exceresis de quiste de epididimo 0.00 10.00 20.00 37.00 67.00 125.00 203.00 243.60

150-22 Prótesis testiculares 0.00 261.00 291.00 442.00 685.00 1,062.00 1,477.00 1,772.40

151-00 Paquetes de urología

151-01 Prostactectomía 0.00 282.00 473.00 879.00 1,591.00 2,933.00 4,908.00 5,889.60

160-00 Ortopedia, amputación o desarticulación

160-01 Brazo 0.00 45.00 86.00 165.00 276.00 462.00 724.00 868.80

160-02 Antebrazo 0.00 50.00 98.00 188.00 318.00 542.00 856.00 1,027.20

160-03 Muslo 0.00 63.00 122.00 236.00 402.00 687.00 1,092.00 1,310.40

160-04 Pierna 0.00 22.00 108.00 301.00 570.00 807.00 1,076.00 1,291.20

160-05 Mano 0.00 38.00 74.00 147.00 239.00 391.00 602.00 722.40

160-06 Pie 0.00 49.00 92.00 178.00 300.00 501.00 789.00 946.80

160-07 Dedo 0.00 11.00 21.00 39.00 77.00 146.00 243.00 291.60

160-08 Ortejo 0.00 11.00 21.00 39.00 77.00 146.00 243.00 291.60

161-00 Artródesis

161-01 Hombro 0.00 68.00 134.00 253.00 440.00 767.00 1,226.00 1,471.20

161-02 Columna 0.00 71.00 137.00 262.00 457.00 795.00 1,265.00 1,518.00

161-03 Cadera 0.00 73.00 146.00 261.00 465.00 828.00 1,361.00 1,633.20

161-04 Artroneumografía 0.00 25.00 47.00 87.00 166.00 323.00 528.00 633.60

161-05 Artródesis 0.00 87.00 168.00 324.00 566.00 992.00 1,586.00 1,903.20

162-00 Coxartrosis y gonardrosis

162-01 Total 0.00 71.00 137.00 262.00 457.00 795.00 1,265.00 1,518.00

162-02 Parcial 0.00 67.00 131.00 251.00 436.00 756.00 1,211.00 1,453.20

163-00 Fractura de cadera

163-01 Artroplastía total 0.00 55.00 276.00 774.00 1,465.00 2,074.00 2,765.00 3,318.00

163-02 Artroplastía parcial 0.00 40.00 200.00 559.00 1,059.00 1,498.00 1,998.00 2,397.60

163-03 Osteosíntesis 0.00 87.00 166.00 323.00 564.00 988.00 1,581.00 1,897.20

163-04 Elongación ósea 0.00 76.00 146.00 278.00 490.00 854.00 1,361.00 1,633.20

163-05 Extirpación discal 0.00 76.00 146.00 278.00 498.00 885.00 1,407.00 1,688.40

163-06 Laminectomia 0.00 93.00 180.00 349.00 614.00 1,079.00 1,710.00 2,052.00

164-00 Hallus valgus

164-01 Unilateral 0.00 34.00 64.00 122.00 218.00 392.00 626.00 751.20

164-02 Bilateral 0.00 47.00 88.00 169.00 299.00 524.00 828.00 993.60

165-00 Luxaciones glenohumeral

165-01 Miembro toráxico reducción manual 0.00 26.00 52.00 97.00 174.00 310.00 500.00 600.00

165-02 Miembro toráxico reducción quirúrgica 0.00 54.00 102.00 198.00 350.00 620.00 980.00 1,176.00

165-03 Radiocarpiana reducción manual 0.00 20.00 39.00 76.00 130.00 227.00 357.00 428.40

165-04 Radiocarpiana reducción quirúrgica 0.00 60.00 116.00 222.00 392.00 701.00 1,133.00 1,359.60

165-05 Dedos reducción manual 0.00 15.00 34.00 64.00 115.00 204.00 326.00 391.20

165-06 Dedos reducción quirúrgica 0.00 34.00 66.00 122.00 215.00 388.00 631.00 757.20

165-07 Miembro pélvico reducción manual 0.00 29.00 58.00 106.00 186.00 328.00 518.00 621.60

165-08 Miembro pélvico reducción quirúrgica 0.00 72.00 135.00 260.00 460.00 813.00 1,303.00 1,563.60

165-09 Rodilla reducción manual 0.00 23.00 47.00 86.00 156.00 289.00 479.00 574.80

165-10 Rodilla reducción quirúrgica 0.00 62.00 117.00 222.00 392.00 701.00 1,133.00 1,359.60

165-11 Tobillo reducción manual 0.00 16.00 34.00 62.00 111.00 199.00 334.00 400.80

165-12 Tobillo reducción quirúrgica 0.00 39.00 74.00 139.00 242.00 428.00 692.00 830.40

165-13 Pie reducción manual 0.00 25.00 50.00 97.00 176.00 324.00 532.00 638.40

165-14 Pie reducción quirúrgica 0.00 63.00 125.00 239.00 427.00 757.00 1,220.00 1,464.00

165-15 Columna reducción manual 0.00 26.00 52.00 97.00 174.00 310.00 504.00 604.80

165-16 Columna reducción quirúrgica 0.00 71.00 130.00 251.00 449.00 801.00 1,279.00 1,534.80




Cuotas (pesos)




165-17 Realización de férulas de yeso 0.00 4.00 5.00 6.00 13.00 25.00 49.00 58.80

166-00 Osteoplatia

166-01 Húmero 0.00 63.00 122.00 236.00 406.00 703.00 1,110.00 1,332.00

166-02 Codo 0.00 68.00 134.00 258.00 447.00 771.00 1,236.00 1,483.20

166-03 Antebrazo 0.00 63.00 122.00 236.00 406.00 703.00 1,110.00 1,332.00

166-04 Mano 0.00 68.00 135.00 258.00 447.00 771.00 1,236.00 1,483.20

166-05 Dedo 0.00 55.00 105.00 203.00 359.00 636.00 1,007.00 1,208.40

166-06 Cadera 0.00 71.00 135.00 263.00 460.00 800.00 1,268.00 1,521.60

166-07 Fémur 0.00 62.00 117.00 228.00 392.00 677.00 1,067.00 1,280.40

166-08 Rodilla 0.00 62.00 117.00 228.00 392.00 677.00 1,067.00 1,280.40

166-09 Tibia y/o peroné 0.00 62.00 117.00 228.00 392.00 677.00 1,067.00 1,280.40

166-10 Tobillo 0.00 68.00 134.00 253.00 440.00 767.00 1,226.00 1,471.20

166-11 Pie 0.00 68.00 134.00 253.00 440.00 767.00 1,226.00 1,471.20

166-12 Columna 0.00 71.00 140.00 271.00 490.00 885.00 1,445.00 1,734.00

167-00 Osteosíntesis

167-01 Húmero 0.00 52.00 105.00 202.00 350.00 610.00 982.00 1,178.40

167-02 Codo 0.00 52.00 101.00 193.00 328.00 558.00 881.00 1,057.20

167-03 Antebrazo 0.00 58.00 110.00 212.00 363.00 620.00 982.00 1,178.40

167-04 Mano 0.00 28.00 138.00 386.00 731.00 1,034.00 1,379.00 1,654.80

167-05 Dedo 0.00 52.00 101.00 193.00 328.00 558.00 881.00 1,057.20

167-06 Cadera 0.00 40.00 200.00 561.00 1,062.00 1,502.00 2,003.00 2,403.60

167-07 Fémur 0.00 37.00 187.00 524.00 992.00 1,404.00 1,872.00 2,246.40

167-08 Rodilla 0.00 30.00 151.00 424.00 802.00 1,135.00 1,514.00 1,816.80

167-09 Menisectomia 0.00 23.00 115.00 322.00 610.00 863.00 1,151.00 1,381.20

167-10 Tibia y/o peroné 0.00 54.00 106.00 205.00 352.00 602.00 951.00 1,141.20

167-11 Tobillo 0.00 52.00 101.00 193.00 328.00 558.00 881.00 1,057.20

167-12 Pie 0.00 34.00 170.00 477.00 903.00 1,277.00 1,703.00 2,043.60

167-13 Columna 0.00 30.00 148.00 415.00 785.00 1,111.00 1,481.00 1,777.20

167-14 Meniscotomia y colocación de prótesis ortopédic 0.00 59.00 113.00 218.00 374.00 644.00 1,017.00 1,220.40

167-15 Liberación de canal 0.00 71.00 130.00 251.00 449.00 801.00 1,279.00 1,534.80

168-00 Osteotomía

168-01 Húmero 0.00 54.00 105.00 203.00 348.00 592.00 935.00 1,122.00

168-02 Codo 0.00 47.00 92.00 176.00 299.00 503.00 789.00 946.80

168-03 Antebrazo 0.00 53.00 264.00 739.00 1,400.00 1,981.00 2,641.00 3,169.20

168-04 Mano 0.00 34.00 170.00 475.00 899.00 1,273.00 1,697.00 2,036.40

168-05 Dedo 0.00 55.00 108.00 210.00 359.00 615.00 966.00 1,159.20

168-06 Cadera 0.00 66.00 126.00 246.00 426.00 736.00 1,160.00 1,392.00

168-07 Fémur 0.00 59.00 113.00 222.00 378.00 645.00 1,026.00 1,231.20

168-08 Rodilla 0.00 58.00 108.00 210.00 359.00 615.00 966.00 1,159.20

168-09 Tibia y/o peroné 0.00 59.00 113.00 222.00 378.00 645.00 1,026.00 1,231.20

168-10 Tobillo 0.00 60.00 116.00 227.00 391.00 673.00 1,058.00 1,269.60

168-11 Pie 0.00 60.00 116.00 227.00 391.00 673.00 1,058.00 1,269.60

168-12 Columna 0.00 29.00 146.00 408.00 772.00 1,093.00 1,457.00 1,748.40

168-13 Prótesis dactilar 0.00 92.00 115.00 166.00 278.00 466.00 689.00 826.80

169-00 Raspa secuestrectomía

169-01 Húmero 0.00 54.00 105.00 203.00 348.00 592.00 935.00 1,122.00

169-02 Codo 0.00 52.00 101.00 193.00 328.00 558.00 881.00 1,057.20

169-03 Antebrazo 0.00 54.00 105.00 203.00 348.00 592.00 935.00 1,122.00

169-04 Mano 0.00 52.00 101.00 193.00 328.00 558.00 881.00 1,057.20

169-05 Dedo 0.00 52.00 101.00 193.00 328.00 558.00 881.00 1,057.20

169-06 Cadera 0.00 59.00 113.00 218.00 374.00 644.00 1,017.00 1,220.40

169-07 Fémur 0.00 53.00 105.00 203.00 348.00 592.00 935.00 1,122.00

169-08 Rodilla 0.00 54.00 105.00 203.00 348.00 592.00 935.00 1,122.00

169-09 Tibia y/o peroné 0.00 54.00 105.00 203.00 348.00 592.00 935.00 1,122.00

169-10 Pie 0.00 47.00 92.00 176.00 292.00 486.00 766.00 919.20

169-11 Columna 0.00 62.00 117.00 228.00 392.00 677.00 1,067.00 1,280.40

169-12 Vendas de yeso c/u (reposición) 0.00 4.00 5.00 6.00 13.00 25.00 49.00 58.80

169-80 Tobillo 0.00 24.00 43.00 84.00 163.00 311.00 510.00 612.00

171-00 Cirugía pediátrica

171-01 Hernioplastía inguinal simple 0.00 38.00 72.00 139.00 261.00 493.00 815.00 978.00

171-02 Hernioplastía inguinal doble 0.00 64.00 117.00 227.00 398.00 694.00 1,119.00 1,342.80

171-03 Hernioplastía umbilical 0.00 35.00 60.00 113.00 193.00 328.00 514.00 616.80

171-04 Hernioplastia diafragmática 0.00 63.00 115.00 222.00 387.00 677.00 1,085.00 1,302.00

171-06 Pilorotomía 0.00 52.00 261.00 730.00 1,382.00 1,955.00 2,607.00 3,128.40

171-07 Desinvaginación del intestino 0.00 60.00 113.00 218.00 373.00 638.00 1,027.00 1,232.40

171-08 Intervención del intestino 0.00 66.00 123.00 237.00 407.00 707.00 1,142.00 1,370.40




Cuotas (pesos)




171-09 Intervenciones esplénicas 0.00 74.00 140.00 271.00 472.00 828.00 1,319.00 1,582.80

171-10 Intervenciones hepáticas 0.00 92.00 174.00 335.00 590.00 1,037.00 1,661.00 1,993.20

171-11 Intervenciones biliares 0.00 77.00 146.00 278.00 490.00 854.00 1,372.00 1,646.40

171-12 Atresias de intestino 0.00 77.00 146.00 278.00 490.00 854.00 1,372.00 1,646.40

171-13 esplenectomia 0.00 63.00 117.00 228.00 392.00 677.00 1,076.00 1,291.20

171-14 Anastómosis de hígado. riñón y t. digestivo 0.00 88.00 165.00 318.00 562.00 995.00 1,603.00 1,923.60

171-15 Atresia de esófago 0.00 77.00 146.00 278.00 491.00 866.00 1,395.00 1,674.00

171-16 Tumorectomías abdominales 0.00 76.00 142.00 276.00 483.00 845.00 1,362.00 1,634.40

171-17 Atresia rectal alta 0.00 76.00 142.00 276.00 490.00 866.00 1,396.00 1,675.20

171-18 Atresia rectal baja 0.00 76.00 142.00 276.00 480.00 837.00 1,352.00 1,622.40

171-19 Colostomía 0.00 53.00 102.00 194.00 334.00 568.00 912.00 1,094.40

171-20 Descenso 0.00 93.00 181.00 350.00 620.00 1,095.00 1,774.00 2,128.80

171-22 Ano cubierto 0.00 72.00 135.00 260.00 454.00 795.00 1,265.00 1,518.00

171-23 Ano humedo 0.00 72.00 135.00 260.00 454.00 795.00 1,265.00 1,518.00

171-25 Oclusión intestinal 0.00 77.00 146.00 278.00 490.00 854.00 1,372.00 1,646.40

171-26 Fístula recto urinaria 0.00 77.00 146.00 278.00 491.00 866.00 1,395.00 1,674.00

171-27 Quiste ideopático 0.00 77.00 146.00 277.00 500.00 900.00 1,454.00 1,744.80

171-28 Perforación de intestino 0.00 71.00 131.00 253.00 437.00 757.00 1,220.00 1,464.00

171-29 Adherencias intestinales 0.00 83.00 156.00 302.00 532.00 935.00 1,511.00 1,813.20

171-30 Absceso residual de pared abdominal 0.00 18.00 34.00 66.00 123.00 226.00 357.00 428.40

171-31 Quiste tirogloso 0.00 39.00 77.00 147.00 290.00 573.00 971.00 1,165.20

171-32 Miectomía 0.00 54.00 110.00 205.00 388.00 736.00 1,232.00 1,478.40

171-33 Eventraciones. bridas. resección 0.00 55.00 105.00 203.00 348.00 592.00 951.00 1,141.20

171-34 Exonfalos simples 0.00 63.00 117.00 228.00 392.00 677.00 1,076.00 1,291.20

171-35 Exonfalos en dos tiempos 0.00 77.00 146.00 278.00 490.00 854.00 1,372.00 1,646.40

171-36 Esténosis uretero piélica unilateral 0.00 522.00 696.00 869.00 1,043.00 1,391.00 1,739.00 2,086.80

171-37 Esténosis uretero piélica bilateral: plastia bilatera 0.00 696.00 927.00 1,159.00 1,391.00 1,855.00 2,318.00 2,781.60

171-38 Fístula branquial (resección de fístula) 0.00 340.00 454.00 567.00 706.00 958.00 1,134.00 1,360.80

171-39 Frenillo lingual corto: frenilectomía 0.00 265.00 353.00 441.00 529.00 706.00 882.00 1,058.40

171-40 Hipospadias: plastía de uretra peneana 0.00 567.00 756.00 567.00 1,134.00 1,512.00 1,890.00 2,268.00

171-41 Desinvaginación por taxis 0.00 454.00 605.00 756.00 907.00 1,210.00 1,512.00 1,814.40

172-00 Cirugía cardiovascular pediátrica

172-01 Blalock 0.00 72.00 130.00 251.00 461.00 847.00 1,396.00 1,675.20

172-02 Anastómosis troncovenoso auricular derecho 0.00 72.00 130.00 251.00 461.00 847.00 1,396.00 1,675.20

172-03 Anastómosis sistemático pulmonar 0.00 72.00 130.00 251.00 461.00 847.00 1,396.00 1,675.20

172-04 Bandaje de arteria pulmonar 0.00 72.00 130.00 251.00 461.00 847.00 1,396.00 1,675.20

172-05 Waterston 0.00 72.00 130.00 251.00 455.00 829.00 1,370.00 1,644.00

172-06 Drenaje de arteria pulmonar 0.00 72.00 130.00 251.00 461.00 847.00 1,396.00 1,675.20

172-07 Derivación espleno renal 0.00 72.00 130.00 251.00 461.00 847.00 1,396.00 1,675.20

172-08 Coartectomía 0.00 66.00 121.00 231.00 423.00 776.00 1,279.00 1,534.80

172-09 Rastelli 0.00 66.00 121.00 231.00 423.00 776.00 1,279.00 1,534.80

172-10 Rastelli con tubo valvulado 0.00 123.00 226.00 432.00 791.00 1,448.00 2,395.00 2,874.00

172-11 Substitución valvular (sin prótesis) 0.00 123.00 226.00 432.00 791.00 1,448.00 2,395.00 2,874.00

172-12 Comisurotomía 0.00 123.00 226.00 432.00 791.00 1,448.00 2,395.00 2,874.00

172-13 Septostomía de raskin 0.00 123.00 226.00 432.00 791.00 1,448.00 2,395.00 2,874.00

172-14 Septostomía transauricular 0.00 123.00 226.00 432.00 791.00 1,448.00 2,395.00 2,874.00

172-15 Anastomosis y blalock 0.00 123.00 226.00 432.00 791.00 1,448.00 2,395.00 2,874.00

172-16 Venocarvoportografía 0.00 66.00 121.00 231.00 423.00 776.00 1,279.00 1,534.80

172-17 Resección paquete varicoso 0.00 66.00 121.00 231.00 423.00 776.00 1,279.00 1,534.80

172-18 Corrección de fístula 0.00 66.00 121.00 231.00 428.00 793.00 1,303.00 1,563.60

172-19 Esplenoportografía 0.00 66.00 121.00 231.00 423.00 776.00 1,279.00 1,534.80

172-22 Corrección drenaje anomalo tot. venas pulm. cie 0.00 123.00 226.00 432.00 791.00 1,448.00 2,395.00 2,874.00

172-23 Sección y sutura de conducto p.c.a. 0.00 108.00 204.00 432.00 791.00 1,448.00 2,395.00 2,874.00

172-24 Cierre de c.i.v. 0.00 72.00 130.00 251.00 461.00 847.00 1,396.00 1,675.20

172-25 Corrección transposición de grandes vasos tgv 0.00 72.00 130.00 251.00 461.00 847.00 1,396.00 1,675.20

172-26 Corrección total de enfermedad de ebstein 0.00 72.00 130.00 251.00 461.00 847.00 1,396.00 1,675.20

172-27 Corrección total del canal a.v. 0.00 72.00 130.00 251.00 461.00 847.00 1,396.00 1,675.20

172-28 Fístula y blalock izquierdo modificado 0.00 108.00 204.00 432.00 791.00 1,448.00 2,395.00 2,874.00

173-00 Neumología pediátrica

173-01 Gasometría 0.00 4.00 6.00 13.00 20.00 33.00 50.00 60.00

173-02 Pruebas funcionales respiratorias 0.00 8.00 13.00 26.00 47.00 81.00 125.00 150.00

174-00 Neurocirugía pediátrica

174-01 Quiste pilonidal 0.00 42.00 83.00 160.00 268.00 451.00 703.00 843.60

174-02 Laminectomía 0.00 35.00 71.00 134.00 224.00 378.00 593.00 711.60

174-03 Plastía de meningocele 0.00 35.00 71.00 134.00 224.00 378.00 593.00 711.60

174-04 Plastía de meningocele craneano 0.00 40.00 78.00 151.00 255.00 428.00 662.00 794.40




Cuotas (pesos)




174-05 Murcelación 0.00 40.00 78.00 151.00 255.00 428.00 662.00 794.40

174-06 Craneoplastía 0.00 33.00 62.00 118.00 199.00 335.00 519.00 622.80

174-07 Creneotomía o craniectomía 0.00 62.00 118.00 229.00 389.00 656.00 1,024.00 1,228.80

174-08 Derivación de líquido cefalorraquídeo 0.00 40.00 81.00 159.00 266.00 447.00 694.00 832.80

174-09 Colocación de reservorio de omaya 0.00 427.00 570.00 712.00 854.00 1,139.00 1,424.00 1,708.80

174-10 Colocación de deriv ventricular periton 0.00 427.00 570.00 712.00 854.00 1,139.00 1,424.00 1,708.80

175-00 Urología pediátrica

175-01 Diálisis peritoneal con equipo 0.00 21.00 38.00 76.00 139.00 252.00 411.00 493.20

175-02 Diálisis peritoneal sin equipo 0.00 5.00 10.00 16.00 33.00 60.00 106.00 127.20

175-03 Hemodiális con equipo 0.00 21.00 38.00 76.00 139.00 252.00 411.00 493.20

175-04 Hemodiális sin equipo 0.00 5.00 10.00 16.00 33.00 60.00 106.00 127.20

175-05 Biopsia renal 0.00 21.00 42.00 78.00 141.00 256.00 416.00 499.20

175-07 Trasplante de riñón-receptor 0.00 123.00 226.00 432.00 791.00 1,448.00 2,395.00 2,874.00

175-08 Trasplante de riñón-donador 0.00 66.00 121.00 231.00 423.00 776.00 1,279.00 1,534.80

175-09 Orquidopexia unilateral 0.00 48.00 93.00 174.00 319.00 588.00 964.00 1,156.80

175-10 Orquidopexia bilateral 0.00 76.00 146.00 278.00 490.00 854.00 1,361.00 1,633.20

175-11 Circuncisión 0.00 26.00 52.00 97.00 179.00 335.00 561.00 673.20

175-12 Circuncisión con plastibel y anestesia 0.00 29.00 58.00 108.00 189.00 334.00 533.00 639.60

175-13 Cicatriz fibrosa del prepucio 0.00 26.00 52.00 97.00 179.00 335.00 561.00 673.20

175-14 Corrección de hipospadias 0.00 35.00 67.00 129.00 223.00 386.00 611.00 733.20

175-16 Reflujo vesicouretral 0.00 49.00 97.00 186.00 324.00 562.00 885.00 1,062.00

175-17 Reimplante de ureteros 0.00 49.00 97.00 186.00 324.00 562.00 885.00 1,062.00

175-18 Valvas posteriores 0.00 45.00 87.00 169.00 302.00 541.00 878.00 1,053.60

175-19 Tumores de vejiga 0.00 45.00 87.00 169.00 302.00 541.00 878.00 1,053.60

176-00 Paquetes de urología pediátrica

176-01 Circuncisión 0.00 91.00 160.00 317.00 564.00 1,013.00 1,650.00 1,980.00

177-00 Neonatología

177-01 Aspiración de secreciones 0.00 23.00 30.00 38.00 45.00 60.00 76.00 91.20

177-02 Fototerapia por día 0.00 11.00 15.00 19.00 23.00 30.00 38.00 45.60

177-03 Fototerapia por 1 hora 0.00 1.00 3.00 4.00 5.00 6.00 8.00 9.60

177-04 Intubación 0.00 15.00 20.00 25.00 30.00 40.00 50.00 60.00

177-05 Uso monitor apnea por día 0.00 8.00 10.00 13.00 15.00 20.00 25.00 30.00

177-06 Uso de monitor neonatal 0.00 19.00 25.00 31.00 38.00 50.00 63.00 75.60

177-07 Preparación alimentación parenteral 0.00 11.00 15.00 19.00 23.00 30.00 38.00 45.60

180-00 Gastroenterología

180-01 Hemorroidectomías 0.00 62.00 116.00 224.00 392.00 687.00 1,096.00 1,315.20

180-02 Extirpación de tumores benignos de ano o recto 0.00 55.00 106.00 205.00 352.00 602.00 966.00 1,159.20

180-03 Debridación de abscesos 0.00 29.00 59.00 110.00 212.00 411.00 711.00 853.20

180-04 Fistulectomías 0.00 42.00 84.00 155.00 287.00 530.00 869.00 1,042.80

180-05 Prolapso rectal 0.00 60.00 116.00 224.00 386.00 663.00 1,045.00 1,254.00

180-06 Colecistectomía 0.00 54.00 105.00 203.00 348.00 592.00 935.00 1,122.00

180-07 Colecistectomía con canales 0.00 63.00 117.00 228.00 392.00 677.00 1,076.00 1,291.20

180-08 Gastrectomía 0.00 59.00 112.00 214.00 367.00 627.00 1,004.00 1,204.80

180-09 Hernias diafragmáticas 0.00 62.00 117.00 228.00 392.00 677.00 1,067.00 1,280.40

180-10 Gastrotomía 0.00 40.00 78.00 151.00 252.00 418.00 664.00 796.80

180-11 Hemicolectomías o colectomías 0.00 37.00 185.00 517.00 978.00 1,384.00 1,846.00 2,215.20

180-12 Resección abdomino perineal 0.00 71.00 134.00 253.00 440.00 767.00 1,246.00 1,495.20

180-13 Transposición de colon 0.00 68.00 134.00 253.00 440.00 767.00 1,226.00 1,471.20

180-14 Laparotomía exploradora 0.00 62.00 117.00 228.00 392.00 677.00 1,067.00 1,280.40

180-15 Resecciones intestinales 0.00 68.00 134.00 253.00 440.00 767.00 1,226.00 1,471.20

180-16 Colostomía o cierre 0.00 26.00 130.00 364.00 689.00 975.00 1,300.00 1,560.00

180-17 Biopsia hepática 0.00 11.00 21.00 39.00 72.00 130.00 209.00 250.80

180-18 Rectosigmoidoscopía 0.00 6.00 11.00 18.00 33.00 58.00 92.00 110.40

180-19 Gastroscopía 0.00 10.00 18.00 37.00 64.00 113.00 175.00 210.00

180-20 Panendoscopía 0.00 10.00 18.00 37.00 64.00 113.00 175.00 210.00

180-21 Colonoscopia 0.00 10.00 18.00 37.00 64.00 113.00 175.00 210.00

180-22 Cirugía menor de esófago 0.00 23.00 48.00 86.00 156.00 289.00 455.00 546.00

180-23 Esclerosis de varices por sesión 0.00 13.00 24.00 45.00 83.00 154.00 236.00 283.20

180-24 Dilataciones esofágicas por sesión 0.00 9.00 14.00 30.00 58.00 105.00 155.00 186.00

180-25 Cirugía menor de recto 0.00 18.00 34.00 66.00 115.00 203.00 316.00 379.20

180-26 Curaciones proctológicas 0.00 5.00 8.00 11.00 18.00 34.00 58.00 69.60

180-27 Curaciones esofágicas 0.00 5.00 8.00 11.00 18.00 34.00 58.00 69.60

180-28 Peritoneoscopías 0.00 13.00 24.00 45.00 78.00 137.00 215.00 258.00

180-29 Cuerpos extraños en esófago y recto 0.00 14.00 28.00 52.00 92.00 160.00 253.00 303.60

180-30 Perfil rectal 0.00 5.00 10.00 16.00 30.00 58.00 92.00 110.40

180-31 Cirugía de páncreas 0.00 63.00 117.00 228.00 392.00 677.00 1,085.00 1,302.00




Cuotas (pesos)




180-32 Abdomen agudo por perforación de víscera huec 0.00 54.00 105.00 203.00 348.00 592.00 935.00 1,122.00

180-33 Endoscopía 0.00 10.00 18.00 37.00 64.00 113.00 175.00 210.00

180-34 Piloroplastía 0.00 73.00 139.00 272.00 462.00 786.00 1,232.00 1,478.40

180-35 Anoplastía perineal 0.00 60.00 118.00 228.00 388.00 661.00 1,045.00 1,254.00

180-36 Rectonectomía 0.00 50.00 100.00 190.00 325.00 557.00 869.00 1,042.80

180-37 Plastia local colesistectomía laparoscópica 0.00 54.00 105.00 203.00 348.00 592.00 935.00 1,122.00

180-38 Colectomía (resección de colon) 0.00 54.00 105.00 203.00 348.00 592.00 935.00 1,122.00

180-39 Apendicectomía por laparoscopía 0.00 86.00 142.00 367.00 567.00 881.00 1,372.00 1,646.40

180-40 Colesistectomía por laparoscopía 0.00 86.00 142.00 367.00 567.00 881.00 1,372.00 1,646.40

181-00 Paquetes de gastroenterología

181-01 Colecistectomía 0.00 233.00 399.00 776.00 1,389.00 2,537.00 4,159.00 4,990.80

181-02 Laparatomía exploradora 0.00 222.00 374.00 723.00 1,283.00 2,328.00 3,855.00 4,626.00

190-00 Viris de inmunodeficiencia humana

190-01 Determinación de carga viral del VIH 0.00 15.00 74.00 149.00 394.00 543.00 743.00 891.60

190-02 Anticuerpos anti-VHC (ELISA) 0.00 29.00 29.00 29.00 47.00 65.00 87.00 104.40

190-03 Paquete plaquetoféresis 0.00 50.00 252.00 706.00 1,336.00 1,890.00 2,520.00 3,024.00

190-04 Detección de anti-cuerpos VIH 1/2 (ELISA) 0.00 29.00 29.00 29.00 46.00 65.00 87.00 104.40

190-05 Antígeno de superficie AgsHB 0.00 26.00 26.00 26.00 42.00 57.00 79.00 94.80

190-06 Paquete componente sanguíneo (P.F.C.P.G.C.P 0.00 9.00 49.00 137.00 259.00 367.00 489.00 586.80

190-07 Eval. react. diagnósticos comerc. detecc. anti-VI 0.00 31,479.00 31,479.00 31,479.00 31,479.00 31,479.00 31,479.00 37,774.80

190-08 Eval. react. diagnósticos comerc. detecc. anti-VH 0.00 26,666.00 26,666.00 26,666.00 26,666.00 26,666.00 26,666.00 31,999.20

190-09 Eval. react. diagnósticos comerc. detecc. Ags-H 0.00 29,262.00 29,262.00 29,262.00 29,262.00 29,262.00 29,262.00 35,114.40

190-10 Crioperservación cultivo celular progenitoras

hematopoyécticas transplante médula ósea 0.00 175.00 874.00 1,748.00 4,632.00 6,379.00 8,739.00 10,486.80

190-11

190-12

Pruebas escrutíneo detecc. anti-VIH mediante

aglutinación pasiva

Prueba confirmatoria detección de anticuerpos

contra virus hepatitis C. (RIBA 3.0)

0.00 31.00 31.00 31.00 31.00 31.00 31.00 37.20

0.00 271.00 271.00 271.00 448.00 616.00 843.00 1,011.60

190-13 Prueba confirmatoria p/detección del antígeno

de

superf. del virus hepatitis B. (AgsHB)

neutralización ABBOT

0.00 59.00 59.00 59.00 98.00 135.00 185.00 222.00

190-14 Eval. react. diagnósticos comerc. anti T.-cruzi 0.00 15,121.00 15,121.00 15,121.00 15,121.00 15,121.00 15,121.00 18,145.20

190-15

Prueba confirmatoria detección de anticuerpos

contra virus de inmunodeficiencia humana (anti-

VIH-1) W.B.

190-16 Eval. react. hemoclasificadores, suero de

coombs

y albúmina bovina, comerciales

0.00 16.00 81.00 227.00 429.00 607.00 811.00 973.20

0.00 10.00 51.00 143.00 272.00 383.00 511.00 613.20

190-17 Eval. hemoderivados comerc. para uso humano 0.00 14.00 67.00 187.00 355.00 504.00 670.00 804.00

190-18 Particip. prog. de evaluación externa calidad de

red

nacional de laboratorios en banco de sangre

0.00 5.00 26.00 76.00 142.00 202.00 270.00 324.00

190-19 Pruebas cruzadas 0.00 7.00 35.00 98.00 186.00 263.00 351.00 421.20

190-20 Transfusión de hemocompuestos 0.00 3.00 15.00 41.00 77.00 109.00 146.00 175.20

191-00 Bacteriología

191-01 Bacteriología en fresco 0.00 4.00 4.00 8.00 14.00 23.00 37.00 44.40

191-02 Bacteriología frotis y tinción 0.00 4.00 4.00 8.00 14.00 23.00 37.00 44.40

191-03 Serotipificaciones 0.00 4.00 5.00 6.00 11.00 20.00 35.00 42.00

191-04 Investigación de plasmodium 0.00 5.00 10.00 15.00 30.00 60.00 100.00 120.00

191-05 Cultivos en general 0.00 5.00 8.00 14.00 26.00 48.00 72.00 86.40

191-11 Cultivos anaerobios 0.00 5.00 6.00 13.00 21.00 39.00 53.00 63.60

192-00 Inmunología

192-01 Estudio de l.c.r. 0.00 8.00 13.00 25.00 47.00 84.00 141.00 169.20

192-02 Estudio de l. ascitis 0.00 8.00 13.00 23.00 42.00 76.00 125.00 150.00

192-03 Estudio de l.peritoneal 0.00 6.00 11.00 20.00 37.00 66.00 108.00 129.60

192-04 Estudio de l. sinovial 0.00 8.00 11.00 21.00 42.00 79.00 135.00 162.00

192-05 Reacciones febriles en placa 0.00 5.00 6.00 11.00 20.00 37.00 64.00 76.80

192-06 Reacciones febriles en tubo 0.00 4.00 5.00 6.00 11.00 20.00 35.00 42.00

192-07 Reacciones febriles en zona 0.00 5.00 6.00 13.00 21.00 37.00 53.00 63.60

192-08 V.d.r.l. cuantitativo 0.00 4.00 5.00 6.00 11.00 20.00 37.00 44.40

192-09 V.d.r.l. cualitativo 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

192-10 Eosinófilos en moco nasal 0.00 3.00 5.00 5.00 10.00 16.00 33.00 39.60




Cuotas (pesos)




192-11 Eosinófilos en esputo 0.00 3.00 5.00 8.00 14.00 28.00 48.00 57.60

192-12 Treponema inmunofluorecencia 0.00 5.00 10.00 17.00 34.00 62.00 97.00 116.40

192-13 Antiestreptolisinas 0.00 4.00 5.00 8.00 14.00 28.00 48.00 57.60

192-14 Proteínas c-reactivas 0.00 4.00 6.00 10.00 16.00 30.00 53.00 63.60

192-15 Factor reumatoide (p. látex r.f.) 0.00 4.00 5.00 10.00 16.00 34.00 53.00 63.60

192-16 R.p.r. prueba de sífilis 0.00 5.00 8.00 14.00 26.00 50.00 77.00 92.40

192-17 I.g.g. 0.00 5.00 10.00 16.00 33.00 63.00 98.00 117.60

192-18 I.g.m. 0.00 5.00 10.00 16.00 33.00 63.00 98.00 117.60

192-19 I.g.a. 0.00 5.00 10.00 16.00 33.00 63.00 98.00 117.60

192-20 I.g.e. 0.00 8.00 14.00 26.00 49.00 91.00 135.00 162.00

0.00 23.00 44.00 74.00 148.00 280.00 429.00 514.80

192-21 Complemento hemolítico c3 0.00 6.00 11.00 18.00 34.00 62.00 100.00 120.00

192-22 Complemento hemolítico c4 0.00 6.00 11.00 18.00 34.00 62.00 100.00 120.00

192-23 Células l.e. 0.00 5.00 6.00 13.00 25.00 47.00 83.00 99.60

192-24 A.c. toxoplasma 0.00 8.00 13.00 25.00 45.00 81.00 123.00 147.60

192-25 A.c. mononucleosis 0.00 6.00 10.00 18.00 35.00 67.00 98.00 117.60

192-26 A.c. dna 0.00 8.00 13.00 25.00 45.00 81.00 123.00 147.60

192-27 A.c. antinúcleo 0.00 8.00 13.00 25.00 45.00 81.00 123.00 147.60

192-28 Ac. Mitocondria 0.00 8.00 13.00 25.00 45.00 81.00 123.00 147.60

192-29 Ac. t.b.g. 0.00 5.00 8.00 14.00 26.00 50.00 77.00 92.40

192-30 Clamidia fluorescencia 0.00 10.00 15.00 33.00 59.00 108.00 159.00 190.80

192-31 Coombs directo 0.00 4.00 6.00 10.00 16.00 30.00 54.00 64.80

192-32 Coombs indirecto 0.00 5.00 8.00 15.00 28.00 50.00 83.00 99.60

192-33 Paul y bunell 0.00 5.00 6.00 13.00 23.00 39.00 54.00 64.80

192-34 Ac. amibiásis 0.00 5.00 8.00 15.00 29.00 52.00 81.00 97.20

192-35 Antígeno carcinoembrionario (c e a) 0.00 11.00 21.00 42.00 79.00 156.00 248.00 297.60

192-36 Alfa feto proteína (a f p) 0.00 10.00 18.00 34.00 66.00 129.00 208.00 249.60

192-37 Antígeno prostático (p a p) 0.00 18.00 35.00 68.00 134.00 258.00 406.00 487.20

192-38 Ferritina 0.00 13.00 25.00 45.00 87.00 169.00 277.00 332.40

192-39 Antígeno extraible del núcleo i (ena i) 0.00 21.00 43.00 83.00 161.00 311.00 495.00 594.00

192-40 Antígeno extraible del núcleo ii (ena ii) 0.00 33.00 66.00 126.00 243.00 475.00 761.00 913.20

192-41 C.a. 15-3 (marcador tumoral) 0.00 18.00 37.00 71.00 137.00 266.00 426.00 511.20

192-42 C.a. 125 (marcador tumoral) 0.00 18.00 37.00 71.00 137.00 266.00 426.00 511.20

192-43 P.g.a. (marcador tumoral) 0.00 13.00 25.00 48.00 92.00 179.00 285.00 342.00

192-44 C.a. 19-9 (marcador tumoral) 0.00 18.00 37.00 71.00 137.00 266.00 426.00 511.20

192-45 Investigación ag asociado a hepatitis 0.00 6.00 11.00 21.00 42.00 79.00 125.00 150.00

192-46 Investigación de a.c. asociados a hepatitis 0.00 6.00 11.00 21.00 42.00 79.00 125.00 150.00

192-47 Investigación ac hla 827 0.00 6.00 11.00 21.00 42.00 79.00 125.00 150.00

192-48 Ac. a histomas músculo esquelético 0.00 6.00 11.00 21.00 42.00 79.00 125.00 150.00

192-49 Anticuerpos antitiroides 0.00 6.00 11.00 21.00 42.00 79.00 125.00 150.00

192-50 Anticuerpos antimúsculo liso 0.00 6.00 11.00 21.00 42.00 79.00 125.00 150.00

192-51 Ac. anticelulares parietales 0.00 6.00 11.00 21.00 42.00 79.00 125.00 150.00

192-52 Cadenas ligeras de inmunoglobulinas 0.00 6.00 11.00 21.00 42.00 79.00 125.00 150.00

192-53 Complemento hemolitico ch-50 0.00 5.00 10.00 15.00 30.00 60.00 100.00 120.00

192-54 Anticuerpos vs. rubeola 0.00 121.00 161.00 202.00 242.00 297.00 403.00 483.60

192-55 Determinación de xilosa 0.00 42.00 55.00 69.00 83.00 111.00 139.00 166.80

192-56 Anti-hepatitis A y B 0.00 1.00 8.00 28.00 58.00 88.00 132.00 158.40

192-57 HIV 0.00 3.00 13.00 48.00 97.00 146.00 221.00 265.20

192-58 Anti-hepatitis C 0.00 3.00 13.00 48.00 97.00 146.00 221.00 265.20

192-59 Determinación de creatina cinasa fracción MB

CPK MB

0.00 6.00 13.00 20.00 40.00 79.00 120.00 144.00

192-60 Determinación de citomegalovirus CMV lgC 0.00 8.00 16.00 27.00 54.00 103.00 160.00 192.00

193-00 Bioquímica

193-01 Glucosa 0.00 4.00 5.00 6.00 11.00 20.00 33.00 39.60

193-02 Glucosa postpandrial 0.00 3.00 4.00 6.00 13.00 21.00 37.00 44.40

193-03 Curva de tolerancia a la glucosa 3 horas 0.00 6.00 11.00 18.00 34.00 60.00 100.00 120.00

193-04 Úrea 0.00 4.00 5.00 8.00 14.00 23.00 37.00 44.40

193-05 N. úrea 0.00 4.00 5.00 6.00 11.00 21.00 37.00 44.40

193-06 Creatinina 0.00 3.00 4.00 5.00 10.00 16.00 33.00 39.60

193-07 Ac. úrico sérico 0.00 4.00 5.00 8.00 14.00 23.00 37.00 44.40

193-08 Bilirrubinas (directa e indirecta) 0.00 4.00 5.00 8.00 14.00 23.00 38.00 45.60

193-09 Proteínas totales 0.00 5.00 9.00 15.00 29.00 53.00 89.00 106.80

193-10 Albúmina 0.00 4.00 5.00 6.00 11.00 20.00 37.00 44.40

193-11 Globulinas 0.00 4.00 5.00 10.00 16.00 33.00 54.00 64.80




Cuotas (pesos)




193-12 Colesterol total 0.00 4.00 6.00 10.00 16.00 33.00 54.00 64.80 193-13 Electroforesis lipoprot. alfa. beta y prebeta 0.00 6.00 8.00 16.00 30.00 59.00 89.00 106.80 193-14 Electroforesis de proteínas 0.00 4.00 8.00 14.00 28.00 53.00 89.00 106.80 193-15 Dopamina 0.00 4.00 6.00 10.00 16.00 30.00 58.00 69.60 193-16 Espermabioscopia 0.00 6.00 11.00 23.00 42.00 76.00 116.00 139.20 193-17 Amonio 0.00 5.00 8.00 15.00 28.00 50.00 83.00 99.60 193-18 Determinación salicilatos en sangre 0.00 6.00 11.00 21.00 42.00 79.00 125.00 150.00 193-19 Reacciones serolutéicas cuantitativas 0.00 6.00 13.00 23.00 45.00 86.00 141.00 169.20 193-20 Ácido láctico 0.00 5.00 10.00 15.00 30.00 60.00 100.00 120.00 193-21 Determinación de niveles séricos (incluye 3 prue 0.00 202.00 202.00 202.00 283.00 283.00 283.00 339.60 193-22 Determinación de niveles séricos: Carbamazepin 0.00 67.00 67.00 67.00 94.00 94.00 94.00 112.80 193-23 Determinación de niveles séricos: Difenilhidantoí 0.00 67.00 67.00 67.00 94.00 94.00 94.00 112.80 193-24 Determinación de niveles séricos: Ácido Valproic 0.00 67.00 67.00 67.00 94.00 94.00 94.00 112.80 193-25 Ph y azúcares reductores (heces) 0.00 15.00 20.00 25.00 30.00 40.00 50.00 60.00 194-00 Enzimas 194-01 T.G.O. 0.00 4.00 5.00 10.00 16.00 33.00 53.00 63.60 194-02 T.G.P. 0.00 4.00 5.00 10.00 16.00 33.00 54.00 64.80 194-03 F.alcalina 0.00 5.00 6.00 11.00 20.00 38.00 67.00 80.40 194-04 F.ácida 0.00 5.00 8.00 15.00 29.00 58.00 92.00 110.40 194-05 F. AC. Fracción prostática 0.00 5.00 10.00 18.00 34.00 60.00 92.00 110.40 194-06 D.H.L. 0.00 5.00 8.00 13.00 23.00 43.00 68.00 81.60 194-07 D.T.P. 0.00 4.00 6.00 10.00 16.00 30.00 53.00 63.60 194-08 Amilasa sérica o urinaria 0.00 5.00 6.00 11.00 20.00 35.00 53.00 63.60 194-09 Lipasa 0.00 5.00 6.00 11.00 20.00 34.00 53.00 63.60 194-10 C.P.K. 0.00 5.00 8.00 13.00 23.00 42.00 66.00 79.20 194-11 D.H.L. isoenzimas 0.00 6.00 11.00 18.00 34.00 63.00 100.00 120.00 194-12 Colinesterasa 0.00 5.00 8.00 13.00 23.00 42.00 64.00 76.80 194-13 L.a.p. (lesinina amino peptitosa) 0.00 4.00 6.00 10.00 16.00 30.00 53.00 63.60 194-14 Alfa 1 antitripsina 0.00 10.00 18.00 33.00 59.00 108.00 169.00 202.80 195-00 Pruebas bas. de func. hepático. renal. digestivo 195-01 Dep. de bromosulfofenoftaleina 0.00 5.00 6.00 13.00 21.00 37.00 53.00 63.60 195-02 Floculación de timol 0.00 4.00 5.00 6.00 11.00 21.00 37.00 44.40 195-03 Turbidez de timol 0.00 4.00 5.00 6.00 11.00 21.00 37.00 44.40 195-04 Flo. de cefalin colesterol 0.00 4.00 5.00 6.00 11.00 21.00 37.00 44.40 195-05 Esterificación de colesterol 0.00 5.00 6.00 13.00 21.00 37.00 53.00 63.60 195-06 Síntesis de úrea 0.00 4.00 5.00 6.00 11.00 21.00 37.00 44.40 195-07 Hierro sérico 0.00 5.00 8.00 15.00 28.00 50.00 83.00 99.60 195-08 Cap. de fij. de hierro 0.00 4.00 5.00 6.00 11.00 21.00 37.00 44.40 195-09 Síntesis de trombina 0.00 6.00 11.00 20.00 37.00 67.00 106.00 127.20 195-10 Ácidos biliares 0.00 6.00 11.00 20.00 37.00 67.00 106.00 127.20 195-11 Concentración 0.00 4.00 5.00 6.00 11.00 21.00 37.00 44.40 195-12 Dep. de creatinina endógena 0.00 5.00 6.00 11.00 20.00 34.00 53.00 63.60 195-13 Relación osmolar 0.00 5.00 6.00 13.00 21.00 38.00 53.00 63.60 195-14 Cuenta minutada 0.00 4.00 6.00 10.00 16.00 33.00 53.00 63.60 195-15 Quimismo gástrico 0.00 4.00 5.00 6.00 11.00 21.00 37.00 44.40 195-16 P.hollander 0.00 4.00 5.00 6.00 11.00 21.00 37.00 44.40 195-17 Tolerancia d-xylosa 0.00 5.00 6.00 13.00 21.00 38.00 53.00 63.60 195-18 Pepsinógeno 0.00 4.00 5.00 6.00 11.00 20.00 37.00 44.40 195-19 Gastrina 0.00 8.00 14.00 25.00 47.00 87.00 135.00 162.00 195-20 Hemoglobina en heces 0.00 4.00 5.00 6.00 11.00 21.00 37.00 44.40 195-21 Carótenos 0.00 5.00 8.00 14.00 26.00 50.00 77.00 92.40 195-22 Prueba de jigrl (prueba de tubo digestivo) 0.00 4.00 5.00 6.00 11.00 21.00 37.00 44.40 195-23 Bilirrubinas (directa e indirecta) 0.00 4.00 5.00 10.00 16.00 33.00 53.00 63.60 196-00 Electrolitos 196-01 Sodio 0.00 4.00 5.00 6.00 11.00 20.00 37.00 44.40 196-02 Potasio 0.00 4.00 5.00 6.00 11.00 20.00 37.00 44.40 196-03 Cloro 0.00 4.00 5.00 6.00 11.00 20.00 37.00 44.40 0.00 12.00 15.00 18.00 33.00 60.00 111.00 133.20 196-04 CO2 0.00 4.00 6.00 10.00 16.00 33.00 53.00 63.60 196-05 PO2 0.00 4.00 5.00 6.00 11.00 20.00 37.00 44.40 196-06 PCO2 0.00 4.00 5.00 6.00 11.00 20.00 37.00 44.40 196-07 PH 0.00 4.00 6.00 10.00 16.00 33.00 53.00 63.60 196-08 Osmolaridad 0.00 4.00 6.00 10.00 16.00 33.00 53.00 63.60 196-09 Magnesio 0.00 5.00 6.00 13.00 21.00 38.00 53.00 63.60 196-10 Litio 0.00 4.00 6.00 10.00 16.00 33.00 53.00 63.60 196-11 Fósforo 0.00 4.00 6.00 10.00 16.00 33.00 53.00 63.60




Cuotas (pesos)




196-12 Calcio 0.00 5.00 6.00 11.00 18.00 34.00 53.00 63.60

196-13 Cloruros 0.00 5.00 10.00 15.00 30.00 60.00 100.00 120.00

196-14 Fosfato de calcio 0.00 5.00 10.00 15.00 30.00 60.00 100.00 120.00

196-16 Alfa I 0.00 6.00 11.00 20.00 37.00 67.00 108.00 129.60

196-17 alfa 2 0.00 4.00 5.00 6.00 11.00 20.00 37.00 44.40

196-18 Beta 0.00 5.00 6.00 13.00 21.00 37.00 53.00 63.60

196-19 Gamma 0.00 4.00 5.00 6.00 11.00 20.00 37.00 44.40

196-20 Relación alb/glob. 0.00 5.00 6.00 13.00 21.00 37.00 53.00 63.60

196-21 Urobilinógeno cuantitativo 0.00 4.00 5.00 6.00 11.00 20.00 37.00 44.40

197-00 Lípidos

197-01 Lípidos totales 0.00 5.00 6.00 13.00 21.00 38.00 54.00 64.80

197-02 Triglicéridos 0.00 5.00 8.00 13.00 23.00 42.00 71.00 85.20

197-04 H.d.l.colesterol(alfa, beta y prebeta lipopr.) 0.00 5.00 6.00 13.00 21.00 38.00 54.00 64.80

197-05 Electrofóresis de lipoproteínas 0.00 6.00 10.00 18.00 33.00 59.00 89.00 106.80

197-06 Grasas en heces 0.00 8.00 10.00 13.00 15.00 20.00 25.00 30.00

198-00 Hormonas

198-01 T.3 0.00 6.00 10.00 18.00 34.00 60.00 91.00 109.20

198-02 T.4 0.00 6.00 10.00 18.00 34.00 60.00 91.00 109.20

198-03 T.4 normalizado 0.00 6.00 10.00 18.00 34.00 60.00 91.00 109.20

198-04 T.S.H. 0.00 6.00 10.00 18.00 34.00 60.00 91.00 109.20

198-05 T.B.G. 0.00 6.00 10.00 18.00 34.00 60.00 91.00 109.20

198-06 Pregnandiol 0.00 6.00 10.00 18.00 34.00 60.00 91.00 109.20

198-07 Pregnantriol 0.00 6.00 10.00 18.00 34.00 60.00 91.00 109.20

198-08 Testosterona 0.00 10.00 18.00 33.00 60.00 111.00 173.00 207.60

198-09 Testosterona libre 0.00 6.00 13.00 23.00 43.00 78.00 125.00 150.00

198-10 Cortisol 0.00 8.00 13.00 26.00 48.00 86.00 125.00 150.00

198-11 Hidroxicorticoesteroides 0.00 6.00 10.00 18.00 34.00 60.00 91.00 109.20

198-12 Cetoesteroides 0.00 6.00 10.00 18.00 34.00 60.00 91.00 109.20

198-13 Cetogénicos 0.00 5.00 6.00 13.00 21.00 38.00 58.00 69.60

198-14 Catecolaminas totales 0.00 6.00 11.00 18.00 34.00 63.00 102.00 122.40

198-15 Adrenalina 0.00 5.00 6.00 13.00 21.00 38.00 58.00 69.60

198-16 Noroadrenalina 0.00 5.00 6.00 13.00 21.00 38.00 58.00 69.60

198-17 Ac. vanilmandélico 0.00 5.00 8.00 16.00 30.00 58.00 86.00 103.20

198-18 Ac. homovanílico 0.00 4.00 6.00 10.00 16.00 34.00 58.00 69.60

198-19 Estriol 0.00 8.00 13.00 26.00 48.00 86.00 125.00 150.00

198-20 Estradiol 0.00 8.00 13.00 26.00 48.00 86.00 125.00 150.00

198-21 Progesterona 0.00 8.00 14.00 28.00 50.00 92.00 141.00 169.20

198-22 Serotomina 0.00 5.00 10.00 16.00 30.00 59.00 91.00 109.20

198-24 Aldosterona 0.00 4.00 5.00 10.00 16.00 30.00 50.00 60.00

198-26 Prueba de thorn 0.00 5.00 6.00 13.00 21.00 39.00 58.00 69.60

198-27 Insulina 0.00 8.00 13.00 26.00 48.00 86.00 125.00 150.00

198-28 Glucagon 0.00 6.00 13.00 23.00 43.00 79.00 127.00 152.40

198-29 H. crecimiento 0.00 8.00 14.00 28.00 50.00 92.00 141.00 169.20

198-30 H.a.c.t. 0.00 5.00 8.00 14.00 26.00 48.00 72.00 86.40

198-31 H.f.e. 0.00 8.00 13.00 25.00 47.00 84.00 127.00 152.40

198-32 H.l. 0.00 8.00 13.00 26.00 48.00 86.00 125.00 150.00

198-33 Prolactina 0.00 8.00 14.00 28.00 50.00 92.00 141.00 169.20

198-34 Antidiurética 0.00 6.00 10.00 18.00 34.00 60.00 91.00 109.20

198-35 Gonadotropina cualitativa 0.00 8.00 14.00 23.00 43.00 78.00 125.00 150.00

198-36 Gonadotropina cuantitativa 0.00 8.00 14.00 28.00 50.00 96.00 149.00 178.80

198-37 Lactógeno placentario 0.00 8.00 13.00 26.00 48.00 86.00 125.00 150.00

198-38 Paratohormona 0.00 11.00 20.00 38.00 68.00 125.00 194.00 232.80

198-39 Fracción "b" gonadotropina 0.00 6.00 10.00 18.00 33.00 58.00 87.00 104.40

199-00 Examen de orina

199-01 Proteínas 0.00 5.00 8.00 15.00 29.00 58.00 91.00 109.20

199-03 Ac. diacético 0.00 3.00 5.00 5.00 10.00 16.00 30.00 36.00

199-05 Mioglobina 0.00 3.00 5.00 5.00 10.00 16.00 30.00 36.00

199-06 Ac. úrico urinario 0.00 3.00 5.00 5.00 10.00 16.00 30.00 36.00

199-07 Hemosiderina en orina 0.00 3.00 5.00 5.00 10.00 16.00 30.00 36.00

199-08 Fenilcetonuria 0.00 4.00 6.00 10.00 16.00 29.00 53.00 63.60

199-09 Sedimento urinario 0.00 4.00 5.00 6.00 11.00 21.00 38.00 45.60

199-10 Células grasas 0.00 4.00 5.00 6.00 11.00 21.00 37.00 44.40

199-11 Investigación de hifas 0.00 4.00 5.00 6.00 11.00 21.00 37.00 44.40

199-14 Proteínas de bence jones 0.00 5.00 10.00 18.00 34.00 63.00 89.00 106.80

199-15 Acetona 0.00 4.00 6.00 10.00 16.00 30.00 53.00 63.60

200-00 Parasitología




Cuotas (pesos)




200-01 Prueba para inducción de parásitos 0.00 6.00 11.00 20.00 35.00 64.00 106.00 127.20

200-02 Ex. coproparasitoscópico en serie 0.00 3.00 5.00 6.00 11.00 20.00 35.00 42.00

200-03 Investigación enterobios 0.00 4.00 5.00 6.00 11.00 20.00 37.00 44.40

200-04 Investigación trofozoitos 0.00 4.00 5.00 6.00 11.00 20.00 37.00 44.40

200-06 Sangre oculta en heces 0.00 4.00 5.00 6.00 11.00 20.00 37.00 44.40

200-07 Examen coprológico 0.00 5.00 6.00 11.00 20.00 38.00 64.00 76.80

200-08 Ameba en fresco 0.00 3.00 4.00 6.00 13.00 21.00 37.00 44.40

201-00 Hematología

201-01 Cta. de eritrocitos 0.00 3.00 3.00 5.00 8.00 15.00 20.00 24.00

201-02 Hemoglobina 0.00 3.00 3.00 5.00 8.00 15.00 20.00 24.00

201-03 Hematrocito 0.00 3.00 3.00 5.00 8.00 15.00 20.00 24.00

201-04 Cta. de leucocitos 0.00 3.00 3.00 5.00 8.00 14.00 20.00 24.00

201-05 Fórmula diferencial 0.00 3.00 3.00 5.00 8.00 14.00 18.00 21.60

201-06 Observaciones especiales 0.00 3.00 5.00 6.00 11.00 20.00 37.00 44.40

201-07 Recuento de plaquetas 0.00 3.00 4.00 5.00 10.00 18.00 30.00 36.00

201-08 Recuento de reticulocitos 0.00 4.00 5.00 6.00 11.00 20.00 33.00 39.60

201-09 Velocidad sedimentación globular 0.00 3.00 3.00 5.00 8.00 14.00 18.00 21.60

201-10 Investigación hematozoarios 0.00 4.00 5.00 10.00 16.00 30.00 48.00 57.60

201-11 Fragilidad globular 0.00 6.00 11.00 18.00 34.00 63.00 100.00 120.00

201-12 Serie roja 0.00 5.00 10.00 15.00 30.00 60.00 100.00 120.00

201-13 Serie blanca 0.00 5.00 10.00 15.00 30.00 60.00 100.00 120.00

201-14 Prueba de bromelina directa 0.00 5.00 10.00 15.00 30.00 60.00 100.00 120.00

201-15 Pruebas cruzadas 0.00 4.00 5.00 6.00 14.00 22.00 39.00 46.80

201-16 Determinación de grupo sanguíneo y factor rh 0.00 4.00 6.00 10.00 16.00 30.00 53.00 63.60

201-18 Biom. hem. parcial (hb. hto. cnhbg. cuent. de leu 0.00 4.00 5.00 6.00 11.00 20.00 33.00 39.60

201-19 Pruebas de tendencia hemorr. (tipa. tp. tt.) 0.00 6.00 11.00 20.00 37.00 66.00 106.00 127.20

201-20 Tiempo de tromboplastina parcial act. (tipa) 0.00 4.00 5.00 10.00 16.00 33.00 53.00 63.60

201-21 Lisis de euglobulinas (fibrinolisis) 0.00 4.00 6.00 10.00 16.00 33.00 53.00 63.60

201-22 Complemento hemolítico 0.00 4.00 6.00 10.00 16.00 33.00 53.00 63.60

201-25 Tinción de hemosiderina en médula ósea 0.00 4.00 5.00 6.00 11.00 20.00 37.00 44.40

201-26 Búsqueda de hemosiderina sérica 0.00 4.00 5.00 6.00 11.00 20.00 37.00 44.40

201-27 Tiempo de sangrado 0.00 3.00 5.00 8.00 14.00 28.00 48.00 57.60

201-28 Prueba de rumpell leede 0.00 3.00 5.00 5.00 10.00 16.00 30.00 36.00

201-29 Tiempo de coagulación 0.00 4.00 5.00 10.00 16.00 29.00 48.00 57.60

201-30 Tiempo de coagulación plasma recalcificado 0.00 3.00 4.00 5.00 10.00 16.00 33.00 39.60

201-31 Tiempo de protombina 0.00 3.00 5.00 6.00 11.00 20.00 37.00 44.40

201-32 Tiempo parcial de tromboplastina 0.00 3.00 4.00 6.00 11.00 20.00 35.00 42.00

201-33 Tiempo de trombina 0.00 5.00 8.00 13.00 23.00 42.00 64.00 76.80

201-34 Consumo de protombina 0.00 5.00 6.00 13.00 21.00 38.00 53.00 63.60

201-35 Retracción del coágulo 0.00 3.00 4.00 6.00 13.00 23.00 34.00 40.80

201-36 Fibrinógeno 0.00 5.00 8.00 15.00 29.00 53.00 83.00 99.60

201-41 Hb a1c y caracterización de hemoglobina 0.00 6.00 10.00 18.00 35.00 67.00 98.00 117.60

201-43 Pancreolouril 0.00 15.00 29.00 59.00 106.00 190.00 299.00 358.80

201-44 Linfocitos cd 4 y cd 8 0.00 11.00 24.00 47.00 81.00 146.00 231.00 277.20

201-45 Plaquetoféresis 0.00 381.00 639.00 1,032.00 1,734.00 2,601.00 4,031.00 4,837.20

201-46 Plasmoferesis 0.00 381.00 639.00 1,032.00 1,734.00 2,601.00 4,031.00 4,837.20

201-47 Aglutina anti "b" 0.00 42.00 55.00 69.00 83.00 111.00 139.00 166.80

202-00 Paquetes de estudio de laboratorio

202-01 Examen general de orina 0.00 4.00 5.00 6.00 11.00 20.00 37.00 44.40

202-02 Examen general de orina c/gonadotropina car. 0.00 6.00 10.00 18.00 35.00 66.00 112.00 134.40

202-03 Biometría hem. com vsg reticulocitos y plaquet 0.00 5.00 6.00 13.00 21.00 38.00 53.00 63.60

202-04 Perfil bioquímico XII 0.00 15.00 29.00 53.00 98.00 180.00 281.00 337.20

202-05 Perfil de lípidos I 0.00 11.00 20.00 39.00 74.00 135.00 198.00 237.60

202-06 Perfil de lípidos II 0.00 11.00 21.00 37.00 71.00 134.00 222.00 266.40

202-07 Química sanguínea III 0.00 8.00 13.00 25.00 47.00 87.00 139.00 166.80

202-08 Química II 0.00 4.00 5.00 8.00 14.00 26.00 43.00 51.60

202-09 Perfil química sanguínea IV 0.00 6.00 11.00 18.00 35.00 64.00 108.00 129.60

202-10 Química sanguínea V 0.00 6.00 10.00 20.00 38.00 72.00 125.00 150.00

202-11 Perfil hepático 0.00 23.00 43.00 81.00 154.00 290.00 466.00 559.20

202-12 Perfil quirúrgico 0.00 16.00 30.00 62.00 112.00 205.00 304.00 364.80

202-13 Perfil reumático 0.00 14.00 25.00 49.00 91.00 165.00 251.00 301.20

202-14 Perfil control de embarazo 0.00 21.00 42.00 78.00 146.00 271.00 411.00 493.20

202-15 Perfil tiroideo 0.00 26.00 50.00 97.00 179.00 331.00 500.00 600.00

202-16 Protocolo centinela de diarrea (3 est. lab) 0.00 19.00 25.00 31.00 38.00 50.00 63.00 75.60

203-00 Antidoping

203-01 Examen antidoping (incluye 4 pruebas) 0.00 269.00 269.00 269.00 415.00 415.00 415.00 498.00




Cuotas (pesos)




203-02 Examen antidoping: cocaína 0.00 67.00 67.00 67.00 104.00 104.00 104.00 124.80

203-03 Examen antidoping: canabinoides 0.00 67.00 67.00 67.00 104.00 104.00 104.00 124.80

203-04 Examen antidoping: opiaceos 0.00 67.00 67.00 67.00 104.00 104.00 104.00 124.80

203-05 Examen antidoping: benzodiacepinas 0.00 67.00 67.00 67.00 104.00 104.00 104.00 124.80

204-00 Laboratorio análisis de alimentos comerc.

204-01 Superficies vivas e inertes 0.00 131.00 131.00 131.00 131.00 131.00 131.00 157.20

204-02 Cenizas 0.00 143.00 143.00 143.00 143.00 143.00 143.00 171.60

204-03 Peso neto 0.00 25.00 25.00 25.00 25.00 25.00 25.00 30.00

204-04 Peso drenado 0.00 25.00 25.00 25.00 25.00 25.00 25.00 30.00

204-05 Conservadores en leche 0.00 14.00 14.00 14.00 14.00 14.00 14.00 16.80

204-06 Índice refractométrico en leche 0.00 25.00 25.00 25.00 25.00 25.00 25.00 30.00

204-07 Aflatoxinas con garantía de calidad 0.00 632.00 632.00 632.00 632.00 632.00 632.00 758.40

204-08 Aflatoxinas sin garantía de calidad 0.00 469.00 469.00 469.00 469.00 469.00 469.00 562.80

204-09 Grasas y aceites en agua residual 0.00 231.00 231.00 231.00 231.00 231.00 231.00 277.20

204-10 Colinesterasa eritrocita método Ellman 0.00 44.00 44.00 44.00 44.00 44.00 44.00 52.80

204-11 Arsénico semi cuantitativo Gutzeit 0.00 147.00 147.00 147.00 147.00 147.00 147.00 176.40

204-12 Arsénico espectrofotométrico en aguas 0.00 156.00 156.00 156.00 156.00 156.00 156.00 187.20

204-13 Sulfitos en carne 0.00 15.00 15.00 15.00 15.00 15.00 15.00 18.00

204-14 Fibra cruda 0.00 148.00 148.00 148.00 148.00 148.00 148.00 177.60

204-15 Grasa método Goldfish 0.00 189.00 189.00 189.00 189.00 189.00 189.00 226.80

300-00 Radiología

300-01 teleterapia (5 a 25 sesiones) 0.00 35.00 67.00 130.00 229.00 407.00 643.00 771.60

300-02 Braquiterapia manual (hosp.72-120 hrs) 0.00 387.00 742.00 1,440.00 1,886.00 2,471.00 7,152.00 8,582.40

300-03 Braquiterapia con selectron (2-4 hrs) 0.00 387.00 742.00 1,440.00 1,886.00 2,471.00 7,152.00 8,582.40

300-04 Terapia superficial 0.00 26.00 52.00 100.00 176.00 314.00 500.00 600.00

300-05 Quimioterapia (intravenosa o intra-arterial) 0.00 20.00 37.00 72.00 127.00 226.00 357.00 428.40

300-06 Estudio clínico preventivo 0.00 77.00 149.00 289.00 512.00 903.00 1,430.00 1,716.00

301-00 Medicina nuclear

301-01 Todos los gamagramas 0.00 20.00 39.00 76.00 134.00 238.00 375.00 450.00

301-02 Perfil tiroideo 0.00 100.00 189.00 367.00 649.00 1,150.00 1,823.00 2,187.60

301-03 Perfil ginecológico 0.00 100.00 189.00 367.00 649.00 1,150.00 1,823.00 2,187.60

301-04 Perfil paratiroideo 0.00 74.00 141.00 273.00 483.00 856.00 1,360.00 1,632.00

301-05 Perfil suprarenal 0.00 74.00 141.00 273.00 483.00 856.00 1,360.00 1,632.00

301-06 Perfil oncológico 0.00 71.00 134.00 260.00 460.00 813.00 1,286.00 1,543.20

301-07 Perfil hipertension renovascular 0.00 74.00 141.00 273.00 483.00 856.00 1,360.00 1,632.00

301-08 Perfil hipofisiario 0.00 100.00 189.00 367.00 649.00 1,150.00 1,823.00 2,187.60

301-09 Perfil perinatológico 0.00 35.00 67.00 130.00 229.00 407.00 643.00 771.60

301-10 Bazo 0.00 139.00 267.00 518.00 917.00 1,624.00 2,575.00 3,090.00

301-11 Cerebro 0.00 116.00 223.00 431.00 771.00 1,381.00 2,147.00 2,576.40

301-12 Corazón 0.00 135.00 261.00 503.00 892.00 1,578.00 2,502.00 3,002.40

301-13 Hígado 0.00 77.00 149.00 289.00 512.00 903.00 1,430.00 1,716.00

301-14 Mama 0.00 77.00 149.00 289.00 512.00 903.00 1,430.00 1,716.00

301-15 Óseo 0.00 76.00 142.00 289.00 512.00 903.00 1,430.00 1,716.00

301-16 Páncreas 0.00 139.00 267.00 518.00 917.00 1,624.00 2,575.00 3,090.00

301-17 Pulmón 0.00 135.00 261.00 503.00 892.00 1,578.00 2,502.00 3,002.40

301-18 Útero 0.00 77.00 149.00 289.00 512.00 903.00 1,430.00 1,716.00

301-19 Venoso 0.00 77.00 149.00 289.00 512.00 903.00 1,430.00 1,716.00

301-20 Rastreo 0.00 117.00 227.00 437.00 779.00 1,385.00 2,176.00 2,611.20

301-21 Tratamiento 0.00 163.00 312.00 605.00 1,070.00 1,894.00 3,004.00 3,604.80

301-22 Mielograma 0.00 13.00 25.00 48.00 86.00 154.00 246.00 295.20

301-23 Esplenograma 0.00 6.00 11.00 20.00 35.00 64.00 106.00 127.20

301-24 Adenograma 0.00 4.00 5.00 8.00 14.00 23.00 37.00 44.40

301-25 Aspirado e interpretación de médula ósea 0.00 6.00 11.00 20.00 35.00 64.00 106.00 127.20

301-26 Esofagografía 0.00 47.00 92.00 178.00 321.00 577.00 920.00 1,104.00

301-27 Neumoperitoneo 0.00 34.00 63.00 123.00 222.00 398.00 631.00 757.20

302-00 Rayos "x"

302-01 B. tórax p.a. 0.00 10.00 18.00 34.00 64.00 122.00 203.00 243.60

302-02 Costillas o esternón (tórax óseo) 0.00 9.00 15.00 29.00 54.00 106.00 173.00 207.60

302-03 Columna vertebral cervical 0.00 9.00 15.00 30.00 59.00 110.00 176.00 211.20

302-04 Columna vertebral dorsal 0.00 11.00 21.00 43.00 81.00 154.00 248.00 297.60

302-05 Columna vertebral lumbosacra 0.00 11.00 23.00 43.00 81.00 154.00 248.00 297.60

302-06 Columna vertebral estudio dinámico 0.00 33.00 64.00 142.00 263.00 488.00 743.00 891.60

302-07 Pelvis a.p. 0.00 6.00 10.00 18.00 35.00 66.00 116.00 139.20

302-08 Cráneo 0.00 8.00 14.00 26.00 49.00 93.00 165.00 198.00

302-09 Macizo facial 0.00 6.00 13.00 23.00 45.00 83.00 134.00 160.80

302-10 Huesos propios de la naríz perfilograma 0.00 6.00 13.00 23.00 45.00 83.00 134.00 160.80




Cuotas (pesos)




302-11 Órbitas por placa 0.00 9.00 15.00 30.00 59.00 110.00 166.00 199.20

302-12 Senos paranasales 0.00 9.00 16.00 33.00 60.00 111.00 174.00 208.80

302-13 Senos paranasales con tomografía 0.00 30.00 63.00 122.00 234.00 451.00 680.00 816.00

302-14 Articulaciones temporomandibulares 0.00 10.00 18.00 34.00 63.00 117.00 179.00 214.80

302-15 Silla turca 0.00 9.00 15.00 30.00 59.00 110.00 166.00 199.20

302-16 Silla turca con tomografía 0.00 30.00 60.00 116.00 213.00 391.00 595.00 714.00

302-17 Oídos schuller 0.00 5.00 6.00 13.00 21.00 38.00 53.00 63.60

302-18 Oídos schuller con tomografía 0.00 18.00 34.00 63.00 115.00 209.00 323.00 387.60

302-19 Mastoides convencional 0.00 10.00 15.00 33.00 60.00 111.00 166.00 199.20

302-20 Conductos auditivos 0.00 6.00 10.00 16.00 33.00 62.00 105.00 126.00

302-21 Mandíbula dos posiciones 0.00 6.00 10.00 18.00 34.00 64.00 97.00 116.40

302-22 Lateral de cuello 0.00 6.00 10.00 18.00 35.00 66.00 110.00 132.00

302-23 Laringe 0.00 4.00 6.00 10.00 18.00 35.00 59.00 70.80

302-24 Laringe con tomografía a.p. 0.00 14.00 25.00 49.00 91.00 165.00 256.00 307.20

302-25 Cuello a.p. y lateral partes blandas 0.00 6.00 9.00 16.00 30.00 58.00 93.00 111.60

302-26 Mano 0.00 6.00 13.00 20.00 37.00 71.00 125.00 150.00

302-27 Manos comparativas 0.00 10.00 18.00 34.00 64.00 122.00 209.00 250.80

302-28 Muñeca, escafoides y carpo 0.00 6.00 10.00 18.00 35.00 66.00 116.00 139.20

302-29 Antebrazo adulto 0.00 6.00 11.00 20.00 38.00 72.00 134.00 160.80

302-30 Codo 0.00 5.00 9.00 15.00 29.00 58.00 100.00 120.00

302-31 Codo comparativo 0.00 6.00 13.00 25.00 47.00 87.00 151.00 181.20

302-32 Húmero 0.00 6.00 11.00 21.00 39.00 76.00 134.00 160.80

302-33 Húmeros comparativos 0.00 6.00 11.00 20.00 38.00 72.00 116.00 139.20

302-34 Hombro 0.00 6.00 13.00 23.00 45.00 83.00 134.00 160.80

302-35 Hombros comparativos 0.00 8.00 14.00 26.00 49.00 93.00 146.00 175.20

302-36 Clavícula 0.00 5.00 10.00 16.00 30.00 59.00 91.00 109.20

302-37 Clavícula comparada 0.00 9.00 15.00 30.00 59.00 110.00 166.00 199.20

302-38 Omóplato 0.00 6.00 11.00 23.00 43.00 81.00 127.00 152.40

302-39 Omóplato comparativo 0.00 14.00 25.00 49.00 91.00 165.00 256.00 307.20

302-40 Pie 0.00 5.00 10.00 16.00 30.00 59.00 91.00 109.20

302-41 Tobillo 0.00 5.00 10.00 16.00 33.00 63.00 97.00 116.40

302-42 Tobillo comparativo 0.00 13.00 23.00 43.00 79.00 146.00 218.00 261.60

302-43 Pierna 0.00 6.00 11.00 23.00 43.00 81.00 127.00 152.40

302-44 Rodilla 0.00 6.00 11.00 23.00 43.00 81.00 127.00 152.40

302-45 Rótula 0.00 6.00 11.00 23.00 43.00 81.00 127.00 152.40

302-46 Rodillas comparativas 0.00 14.00 25.00 49.00 91.00 165.00 256.00 307.20

302-47 Fémur a.p. 0.00 9.00 14.00 30.00 58.00 108.00 163.00 195.60

302-48 Fémur a.p. v.l. 0.00 14.00 25.00 49.00 91.00 165.00 256.00 307.20

302-49 Fémur comparativo 0.00 18.00 34.00 63.00 115.00 209.00 323.00 387.60

302-50 Medición de miembro pélvico 0.00 9.00 15.00 30.00 59.00 110.00 166.00 199.20

302-51 Edad ósea 0.00 6.00 11.00 18.00 35.00 68.00 111.00 133.20

302-52 Abdomen simple 0.00 14.00 26.00 50.00 92.00 171.00 263.00 315.60

302-53 Céfalo pelvimetria 0.00 15.00 29.00 58.00 105.00 190.00 289.00 346.80

303-00 Estudios especiales

303-01 Histerosalpingografía 0.00 34.00 63.00 123.00 224.00 412.00 631.00 757.20

303-02 Galactografía 0.00 10.00 15.00 33.00 59.00 108.00 163.00 195.60

303-03 Mamografía 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

303-04 Urografía excretora adulto 0.00 38.00 72.00 141.00 258.00 473.00 721.00 865.20

303-05 Urografía excretora infantil 0.00 29.00 55.00 110.00 199.00 365.00 561.00 673.20

303-06 Urografía excretora cronometrada maxwell 0.00 43.00 84.00 161.00 296.00 544.00 832.00 998.40

303-07 Urografía excretora por perfusión arata 0.00 50.00 98.00 190.00 349.00 638.00 975.00 1,170.00

303-08 Uretrosistografía 0.00 24.00 45.00 89.00 163.00 294.00 449.00 538.80

303-09 Cistografía retrograda 0.00 26.00 49.00 96.00 174.00 319.00 488.00 585.60

303-10 Sialografía 0.00 14.00 26.00 53.00 98.00 179.00 271.00 325.20

303-11 Broncografía 0.00 34.00 66.00 127.00 234.00 427.00 651.00 781.20

303-12 Fistulografía 0.00 18.00 37.00 71.00 129.00 237.00 360.00 432.00

303-13 Laringografía 0.00 20.00 38.00 72.00 131.00 243.00 379.00 454.80

303-14 Mielografía lumbar.dorsal. cervical 0.00 73.00 141.00 273.00 500.00 915.00 1,409.00 1,690.80

303-15 Flebografía bilateral 0.00 34.00 66.00 127.00 234.00 427.00 651.00 781.20

303-16 Artrografía 0.00 13.00 25.00 49.00 91.00 164.00 253.00 303.60

303-17 Arteriografía periférica o aortografía 0.00 83.00 160.00 306.00 564.00 1,039.00 1,590.00 1,908.00

303-18 Arteriografía viceral. pulmonar o cerebral 0.00 106.00 198.00 394.00 721.00 1,320.00 2,040.00 2,448.00

303-19 Extracción de cálculos. dilatación. angiop. 0.00 106.00 204.00 394.00 721.00 1,320.00 2,040.00 2,448.00

303-20 Colecistografia (oral) 0.00 29.00 59.00 115.00 210.00 386.00 591.00 709.20

303-21 Colangiografia por perfusión 0.00 24.00 45.00 89.00 163.00 299.00 451.00 541.20

303-22 Colangio por sonda 0.00 25.00 49.00 93.00 173.00 318.00 488.00 585.60




Cuotas (pesos)




303-23 Colon por enema 0.00 34.00 63.00 123.00 226.00 416.00 631.00 757.20

303-24 Serie esófago gastroduodenal 0.00 34.00 66.00 127.00 234.00 427.00 651.00 781.20

303-25 Tránsito intestinal 0.00 34.00 66.00 127.00 234.00 427.00 651.00 781.20

303-26 Tránsito intestinal con serie esóf. gastroduod 0.00 60.00 116.00 224.00 411.00 751.00 1,155.00 1,386.00

303-27 Colangiografía percutánea 0.00 47.00 92.00 178.00 325.00 595.00 920.00 1,104.00

303-28 Serie cardiaca 0.00 28.00 54.00 106.00 193.00 354.00 542.00 650.40

303-29 Angiografía selectiva abdominal 0.00 34.00 66.00 127.00 228.00 413.00 651.00 781.20

303-30 Angiografía cerebral 0.00 29.00 55.00 110.00 194.00 349.00 561.00 673.20

303-31 Pielografía ascendente 0.00 34.00 66.00 127.00 228.00 413.00 651.00 781.20

303-32 Dacrosistografía 0.00 10.00 15.00 33.00 59.00 102.00 163.00 195.60

303-33 Bulbografía 0.00 73.00 141.00 273.00 491.00 885.00 1,409.00 1,690.80

303-34 Pielografía retrógrada 0.00 34.00 66.00 127.00 228.00 413.00 651.00 781.20

303-35 Cistoscopía 0.00 62.00 118.00 220.00 382.00 664.00 1,041.00 1,249.20

303-36 Estudios de holter 0.00 25.00 50.00 96.00 166.00 291.00 451.00 541.20

304-00 Tomografías lineales

304-01 Tomografía de columna vertebral cervical 0.00 25.00 49.00 97.00 173.00 302.00 478.00 573.60

304-02 Tomografía de columna vertebral dorsal 0.00 37.00 68.00 135.00 239.00 423.00 661.00 793.20

304-03 Tomografía de columna vertebral lumbar 0.00 37.00 68.00 135.00 239.00 423.00 661.00 793.20

304-04 Tomografía pulmonar 0.00 49.00 91.00 175.00 310.00 548.00 877.00 1,052.40

304-05 Tomografía lineal de columna con medio de c. 0.00 54.00 105.00 202.00 355.00 629.00 1,002.00 1,202.40

304-06 Nefrotomografía simple - columna 0.00 59.00 111.00 215.00 384.00 678.00 1,072.00 1,286.40

304-07 Tomografía laringe 0.00 98.00 131.00 164.00 197.00 262.00 328.00 393.60

305-00 Tomografías computadas

305-01 Tomografías computadas simpl. de cualquier reg 0.00 62.00 116.00 228.00 404.00 717.00 1,126.00 1,351.20

305-02 Tomografías computadas con medio contraste 0.00 105.00 203.00 391.00 696.00 1,240.00 1,949.00 2,338.80

306-00 Ultrasonido

306-01 Ultrasonido una región 0.00 20.00 37.00 68.00 125.00 226.00 373.00 447.60

306-02 Ultrasonido dos regiones 0.00 28.00 49.00 97.00 175.00 316.00 512.00 614.40

306-03 Sonografía 0.00 10.00 18.00 37.00 64.00 113.00 175.00 210.00

306-04 Foliculograma 0.00 20.00 37.00 68.00 125.00 226.00 373.00 447.60

306-05 Ultrasonido con transductor 0.00 1.00 5.00 14.00 26.00 37.00 50.00 60.00

307-00 Resonancia magnética

307-01 Estudio normal de una región 0.00 38.00 74.00 150.00 304.00 600.00 1,200.00 1,440.00

307-02 Estudio de una región con medio de contraste 0.00 92.00 184.00 367.00 735.00 1,468.00 2,937.00 3,524.40

307-03 Estudio normal de dos regiones 0.00 39.00 77.00 154.00 309.00 616.00 1,232.00 1,478.40

307-04 Estudio dos regiones con medio de contraste 0.00 94.00 190.00 381.00 760.00 1,518.00 3,038.00 3,645.60

307-05 Estudio normal de tres regiones 0.00 43.00 86.00 169.00 339.00 678.00 1,356.00 1,627.20

307-06 Estudio tres regiones con medio de contraste 0.00 149.00 297.00 595.00 1,189.00 2,379.00 4,758.00 5,709.60

310-00 Patología

310-01 Apéndice ceccol. vesícula biliar 0.00 9.00 15.00 33.00 58.00 98.00 155.00 186.00

310-02 Tumores pequeños de mama 0.00 6.00 11.00 23.00 39.00 68.00 106.00 127.20

310-03 Tumores benignos de mama (pieza mayor) 0.00 16.00 34.00 64.00 112.00 194.00 304.00 364.80

310-04 Resecciones intestinales sin tumor 0.00 10.00 18.00 35.00 62.00 106.00 161.00 193.20

310-05 Resecciones intestinales con tumor 0.00 11.00 21.00 43.00 74.00 129.00 197.00 236.40

310-06 Tumores de glándulas salivales s/disección 0.00 11.00 21.00 43.00 74.00 129.00 197.00 236.40

310-07 Tumores de glándulas salivales c/disección 0.00 15.00 34.00 64.00 112.00 194.00 304.00 364.80

310-08 Estómago sin tumor 0.00 6.00 14.00 26.00 47.00 79.00 125.00 150.00

310-09 Estómago con tumor 0.00 14.00 26.00 49.00 87.00 154.00 242.00 290.40

310-10 Segmentos o lóbulos pulmonares 0.00 9.00 18.00 34.00 60.00 102.00 161.00 193.20

310-11 Próstata 0.00 10.00 15.00 35.00 62.00 106.00 161.00 193.20

310-12 Riñón sin tumor 0.00 10.00 18.00 35.00 62.00 106.00 163.00 195.60

310-13 Riñón con tumor 0.00 11.00 21.00 39.00 71.00 123.00 194.00 232.80

310-14 Testículos sin tumor 0.00 9.00 15.00 29.00 50.00 91.00 140.00 168.00

310-15 Testículos con tumor 0.00 13.00 21.00 42.00 72.00 126.00 194.00 232.80

310-17 tumores retroperitoneales 0.00 13.00 25.00 48.00 91.00 173.00 273.00 327.60

310-16 Extremidades con gangrena o infección 0.00 14.00 26.00 49.00 87.00 154.00 242.00 290.40

310-17 Tumores retroperitoneales 0.00 13.00 25.00 48.00 91.00 173.00 273.00 327.60

310-18 Amígdalas 0.00 6.00 11.00 23.00 39.00 71.00 111.00 133.20

310-19 Ganglio linfatico 0.00 9.00 15.00 33.00 58.00 98.00 155.00 186.00

310-20 Médula ósea 0.00 14.00 26.00 49.00 87.00 154.00 242.00 290.40

310-21 Bazo 0.00 13.00 21.00 42.00 72.00 126.00 194.00 232.80

310-22 Laringe sin disección de cuello 0.00 14.00 28.00 50.00 89.00 155.00 247.00 296.40

310-23 Laringe con disección de cuello 0.00 15.00 33.00 62.00 108.00 190.00 301.00 361.20

310-24 Tiroides sin disección de cuello 0.00 13.00 21.00 43.00 76.00 130.00 202.00 242.40

310-25 Tiroides con disección de cuello 0.00 15.00 30.00 59.00 105.00 188.00 301.00 361.20

310-26 Inmunofluorescencia 0.00 6.00 11.00 23.00 39.00 71.00 111.00 133.20




Cuotas (pesos)




310-27 Inmuno-peroxidasa 0.00 6.00 11.00 23.00 39.00 71.00 111.00 133.20

310-28 Anticuerpos monoclonales 0.00 6.00 11.00 23.00 39.00 71.00 111.00 133.20

310-29 Microscopía electrónica 0.00 6.00 11.00 23.00 39.00 71.00 111.00 133.20

310-30 Revisión de laminillas 0.00 6.00 11.00 23.00 39.00 71.00 111.00 133.20

310-31 Laminillas para otra institución 0.00 6.00 11.00 23.00 39.00 71.00 111.00 133.20

310-32 Biopsia por saca-bocado de piel (punch) 0.00 6.00 11.00 23.00 39.00 71.00 111.00 133.20

310-33 Biopsia incisional de piel 0.00 6.00 11.00 23.00 39.00 71.00 111.00 133.20

310-34 Biopsia para rasurado de piel 0.00 6.00 11.00 23.00 39.00 71.00 111.00 133.20

310-35 Biopsia por coretaje de piel 0.00 6.00 11.00 23.00 39.00 71.00 111.00 133.20

310-37 Pieza quirúrgica de piel 0.00 11.00 21.00 43.00 74.00 129.00 197.00 236.40

310-38 Cariotipo simple 0.00 13.00 24.00 48.00 84.00 147.00 231.00 277.20

310-39 Cariotipo con bandas 0.00 11.00 21.00 43.00 74.00 129.00 197.00 236.40

310-40 Sexocromatina 0.00 11.00 21.00 42.00 72.00 126.00 197.00 236.40

310-41 Electroforesis 0.00 9.00 18.00 34.00 60.00 102.00 161.00 193.20

310-42 Tamis metabólico 0.00 9.00 18.00 34.00 60.00 102.00 161.00 193.20

310-43 Papanicolau cérvico vaginal 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

310-44 Serie hormonal 0.00 5.00 8.00 13.00 21.00 38.00 66.00 79.20

310-45 Espectoración en serie 0.00 16.00 35.00 67.00 117.00 208.00 323.00 387.60

310-46 Cepillado y lavado 0.00 5.00 8.00 15.00 28.00 48.00 74.00 88.80

310-47 Ascitis líquido pleural y líquido cefaloraq. 0.00 11.00 21.00 42.00 72.00 126.00 197.00 236.40

310-48 Orina en serie 0.00 11.00 21.00 42.00 72.00 126.00 197.00 236.40

310-49 Pulmón glándula mamaria. Tiroides gangl. linf. 0.00 6.00 11.00 23.00 39.00 71.00 111.00 133.20

310-50 Próstata tejido blando huesos 0.00 6.00 11.00 23.00 42.00 72.00 111.00 133.20

310-51 Citologia gastrica 0.00 9.00 15.00 29.00 50.00 89.00 139.00 166.80

310-52 Biopsias peq. cervix endom. estom. esof. intest. 0.00 10.00 16.00 34.00 60.00 106.00 166.00 199.20

310-53 Ovarios sin tumor 0.00 8.00 14.00 28.00 48.00 83.00 127.00 152.40

310-54 Útero sin anexos 0.00 10.00 16.00 34.00 60.00 106.00 166.00 199.20

310-55 Ovarios con tumor 0.00 6.00 14.00 26.00 47.00 83.00 130.00 156.00

310-56 Útero con anexos 0.00 11.00 20.00 38.00 67.00 117.00 186.00 223.20

310-57 Exenteración anterior y posterior 0.00 18.00 34.00 64.00 113.00 198.00 306.00 367.20

310-58 Exenteración total 0.00 16.00 34.00 64.00 113.00 198.00 306.00 367.20

310-59 Fetos hasta 4 1/2 meses 0.00 11.00 21.00 43.00 74.00 129.00 197.00 236.40

310-60 Placenta 0.00 6.00 11.00 23.00 39.00 68.00 108.00 129.60

310-61 Biopsia de hígado y riñón 0.00 11.00 21.00 43.00 74.00 129.00 197.00 236.40

310-62 Toma y estudio de médula ósea 0.00 3.00 11.00 42.00 88.00 131.00 202.00 242.40

320-00 Alergia

320-01 Citología de moco nasal 0.00 3.00 5.00 5.00 10.00 15.00 29.00 34.80

320-02 Proteosa autovacuna 0.00 11.00 21.00 39.00 71.00 125.00 197.00 236.40

320-03 Preciptiva 0.00 10.00 18.00 39.00 71.00 123.00 190.00 228.00

320-04 Inmunoterapia (vacunas específicas) 0.00 6.00 11.00 21.00 38.00 67.00 108.00 129.60

320-05 Pruebas cutáneas intradérmicas 1 serie 0.00 4.00 5.00 10.00 16.00 29.00 48.00 57.60

320-06 Pruebas cutáneas intradérmicas 2 series 0.00 5.00 10.00 18.00 33.00 59.00 89.00 106.80

320-07 Pruebas cutáneas intradérmicas 3 series 0.00 6.00 11.00 21.00 38.00 67.00 108.00 129.60

320-08 Pruebas cutáneas por transferencias 1 serie 0.00 5.00 10.00 18.00 33.00 59.00 89.00 106.80

320-09 Pruebas cutáneas por transferencias 2 series 0.00 8.00 14.00 33.00 58.00 101.00 155.00 186.00

320-10 Pruebas cutáneas por transferencias 3 series 0.00 11.00 24.00 47.00 81.00 146.00 231.00 277.20

330-00 Infectología

330-05 Citología de l.c.r. 0.00 3.00 5.00 5.00 10.00 15.00 29.00 34.80

330-07 Cultivo en orina y bacterioscópico baar (t b) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

330-08 Tinción de machiavelo 0.00 5.00 6.00 13.00 21.00 37.00 53.00 63.60

330-12 Serología de amiba por hemoglutinación indir. 0.00 3.00 4.00 5.00 8.00 13.00 18.00 21.60

340-00 Tratamiento terapéutico "clínica del dolor"

340-01 Bloqueo rama trigeminal 0.00 5.00 8.00 15.00 29.00 52.00 86.00 103.20

340-02 Bloqueo ganglio gaser 0.00 6.00 11.00 18.00 35.00 66.00 105.00 126.00

340-03 Bloqueo de ramas trigeminales terminales 0.00 3.00 5.00 6.00 11.00 20.00 37.00 44.40

340-04 Bloqueo de nervio lingual 0.00 5.00 9.00 15.00 29.00 53.00 92.00 110.40

340-05 Bloqueo de nervio gloso faríngeo 0.00 6.00 11.00 18.00 35.00 66.00 105.00 126.00

340-06 Bloque de ganglio esfenopalatino 0.00 5.00 9.00 15.00 29.00 53.00 92.00 110.40

340-07 Bloqueo de nervio occipital 0.00 3.00 5.00 10.00 16.00 33.00 49.00 58.80

340-08 Bloqueo de raíz cervical profunda 0.00 3.00 6.00 10.00 16.00 34.00 54.00 64.80

340-09 Bloqueo de plexo cervical superficial 0.00 3.00 5.00 6.00 11.00 20.00 37.00 44.40

340-10 Bloqueo de nervio faríngeo 0.00 3.00 6.00 10.00 16.00 34.00 54.00 64.80

340-11 Bloqueo de nervio frénico 0.00 3.00 5.00 10.00 16.00 33.00 49.00 58.80

340-12 Bloqueo de nervio supraescapular 0.00 3.00 5.00 10.00 16.00 33.00 49.00 58.80

340-13 Bloqueo simpático servicodorsal c/contr. r. x 0.00 8.00 14.00 25.00 47.00 87.00 141.00 169.20

340-14 Bloqueo simpático servicodorsal s/contr. r. x 0.00 6.00 11.00 18.00 35.00 66.00 105.00 126.00




Cuotas (pesos)




340-15 Bloqueo peridual anti-inflamat. sin medicamento 0.00 5.00 9.00 15.00 29.00 53.00 92.00 110.40

340-16 Bloqueo peridual lítico 0.00 3.00 5.00 6.00 11.00 20.00 37.00 44.40

340-17 Bloqueo subaragnoideo lítico 0.00 11.00 20.00 37.00 67.00 125.00 203.00 243.60

340-18 Bloqueo paravertebral 0.00 3.00 5.00 10.00 16.00 33.00 49.00 58.80

340-19 Bloqueo de nervios intercostales 0.00 3.00 5.00 10.00 16.00 33.00 49.00 58.80

340-20 Bloqueo de nervio abdominogenital 0.00 3.00 5.00 10.00 16.00 33.00 49.00 58.80

340-21 Bloqueo de nervio crural 0.00 3.00 5.00 10.00 16.00 33.00 49.00 58.80

340-22 Bloqueo de nervio fermorocutáneo 0.00 3.00 5.00 10.00 16.00 33.00 49.00 58.80

340-23 Bloqueo de nervio obturador 0.00 3.00 5.00 6.00 11.00 20.00 37.00 44.40

340-24 Bloqueo de nervio ciático 0.00 3.00 4.00 6.00 11.00 20.00 37.00 44.40

340-25 Bloqueo de articulacion sacro-ilíaca 0.00 3.00 5.00 10.00 16.00 33.00 49.00 58.80

340-26 Bloqueo de articulacion coxo-femoral 0.00 3.00 5.00 10.00 16.00 33.00 49.00 58.80

340-27 Bloqueo de nervio safeno 0.00 3.00 5.00 6.00 11.00 20.00 37.00 44.40

340-28 Bloqueo trans-sacro 0.00 3.00 5.00 10.00 16.00 33.00 49.00 58.80

340-29 Bloqueo de ramas terminales de miembros pelv. 0.00 3.00 5.00 10.00 16.00 33.00 49.00 58.80

340-29 Bloqueo de ramas terminales de miembros pelv. 0.00 3.00 5.00 10.00 16.00 33.00 49.00 58.80

340-30 Bloqueo de articulación de rodillas 0.00 3.00 5.00 10.00 16.00 33.00 49.00 58.80

340-31 Bloque caudal 0.00 3.00 5.00 10.00 16.00 33.00 49.00 58.80

340-32 Bloqueo de bursa anterior de hombro 0.00 3.00 5.00 6.00 11.00 20.00 37.00 44.40

340-33 Bloqueo de plexo bronquial 0.00 3.00 5.00 6.00 11.00 20.00 37.00 44.40

340-34 Bloqueos periféricos de miembros superiores 0.00 3.00 5.00 6.00 11.00 20.00 37.00 44.40

340-35 Bloqueo de ganglio simpático lumb. contr. r. x 0.00 14.00 26.00 50.00 93.00 173.00 276.00 331.20

340-36 Bloqueo de ganglio esplacico celiaco c/r.x 0.00 14.00 26.00 50.00 93.00 173.00 276.00 331.20

340-37 Bloqueo de cápsula de hombro 0.00 3.00 5.00 6.00 11.00 20.00 37.00 44.40

340-38 Bloqueo perivascular de arteria temporal 0.00 3.00 5.00 6.00 11.00 20.00 37.00 44.40

340-39 Estimulación eléctrica cutánea 0.00 3.00 5.00 6.00 11.00 20.00 37.00 44.40

350-00 Terapia intensiva

350-01 Día estancia en terapia intensiva (urgencias) 0.00 29.00 55.00 110.00 193.00 346.00 549.00 658.80

350-03 Electrocardiograma 0.00 6.00 10.00 18.00 33.00 58.00 89.00 106.80

350-07 Alimentación artificial por día 0.00 8.00 14.00 29.00 52.00 92.00 142.00 170.40

360-00 Auxiliares de tratamiento

360-01 Lavado gástrico 0.00 8.00 14.00 28.00 52.00 98.00 165.00 198.00

360-02 Sondeo vesical 0.00 8.00 13.00 23.00 45.00 83.00 141.00 169.20

360-03 Venoclisis 0.00 8.00 14.00 28.00 52.00 100.00 169.00 202.80

360-04 Aplicación de inyecciones intravenosas 0.00 4.00 6.00 10.00 16.00 30.00 54.00 64.80

360-05 Aplicación de inyecciones intramusculares 0.00 3.00 4.00 5.00 10.00 18.00 33.00 39.60

360-06 Vendajes compresivos 0.00 6.00 9.00 16.00 30.00 59.00 91.00 109.20

360-07 Retiro de yeso 0.00 4.00 5.00 10.00 16.00 33.00 54.00 64.80

360-08 Sangría 0.00 11.00 20.00 39.00 72.00 130.00 202.00 242.40

360-09 Punción vesical suprapúbica 0.00 28.00 54.00 101.00 189.00 354.00 602.00 722.40

360-10 Radioterapia por sesión 0.00 3.00 5.00 6.00 11.00 20.00 37.00 44.40

360-11 Curaciones 0.00 5.00 8.00 13.00 23.00 43.00 76.00 91.20

360-12 Inhaloterapia por sesión 0.00 3.00 4.00 5.00 10.00 16.00 30.00 36.00

360-13 Lavado de oídos 0.00 3.00 4.00 5.00 10.00 16.00 30.00 36.00

370-00 Servicios diversos

370-01 Vacuna antirrábica humana 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

370-02 Vacuna antirrábica canina 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

370-03 Día jaula para perro 0.00 28.00 28.00 37.00 37.00 37.00 37.00 44.40

370-04 Inscripción club de madres 0.00 3.00 6.00 13.00 18.00 26.00 37.00 44.40

370-05 Mensualidad club de madres 0.00 6.00 6.00 13.00 15.00 18.00 20.00 24.00

370-06 Inscripción guarderías 0.00 10.00 10.00 13.00 13.00 13.00 13.00 15.60

370-07 Mensualidad guarderias 0.00 11.00 23.00 45.00 58.00 71.00 89.00 106.80

370-08 Tarjeta de salud 0.00 20.00 20.00 25.00 25.00 25.00 25.00 30.00

370-09 Utilización de mortuaorio 0.00 3.00 3.00 5.00 6.00 6.00 6.00 7.20

370-10 Servicio de reposición de carnet 0.00 5.00 6.00 13.00 15.00 18.00 20.00 24.00

370-11 Certificado prenupcial (incluye v.d.r.l. y tórax) 0.00 10.00 20.00 37.00 58.00 86.00 123.00 147.60

370-12 Certificado médico (únicamente expedición) 0.00 10.00 10.00 13.00 13.00 13.00 13.00 15.60

370-13 Certificado internacional de vacunación 0.00 20.00 38.00 74.00 92.00 116.00 147.00 176.40

370-14 Constancia de nacimiento 0.00 5.00 6.00 13.00 15.00 18.00 20.00 24.00

370-16 Desinsectización m2 0.00 0.00 0.00 3.00 3.00 4.00 4.00 4.80

370-17 Desinfección m2 0.00 0.00 0.00 3.00 3.00 4.00 4.00 4.80

370-18 Desratización con anticoagulante 500 gr. 0.00 3.00 3.00 4.00 5.00 5.00 6.00 7.20

370-22 Servicio de fumigación por exhumación de cad. 0.00 192.00 287.00 493.00 591.00 708.00 862.00 1,034.40

370-26 Expedición de credencial 0.00 20.00 20.00 25.00 25.00 25.00 25.00 30.00

370-29 Serv. de ambul. p/trasl. de enf. y cadav. p/km. 0.00 3.00 3.00 3.00 3.00 4.00 6.00 7.20

370-30 Serv. de ambulancia s/med. D.F. cualquier zona 0.00 77.00 154.00 294.00 387.00 504.00 675.00 810.00




Cuotas (pesos)




370-31 Serv. ambulancia s/med. Nezahualcóyotl 0.00 48.00 96.00 184.00 239.00 311.00 404.00 484.80

370-32 Serv. de ambulancia s/med. Tlalnepantla 0.00 67.00 135.00 258.00 330.00 422.00 542.00 650.40

370-33 Serv. de ambulancia s/med. Ecatepec 0.00 67.00 135.00 258.00 330.00 422.00 542.00 650.40

370-34 Serv. de ambulancia s/med. Cuautitlán 0.00 77.00 154.00 294.00 387.00 504.00 675.00 810.00

370-35 Serv. de ambulancia s/med. Naucalpan 0.00 67.00 135.00 258.00 330.00 422.00 542.00 650.40

370-36 Serv. de ambulancia s/med. a entidades federati 0.00 3.00 3.00 3.00 3.00 4.00 6.00 7.20

370-37 Fotocopia 0.00 0.50 0.50 0.50 0.50 0.50 0.50 0.60

400-00 Estudios de Fluroscopia

Solo el equipo de Fluoroscopia Incluye: Dos

400-01 placas 15 ml. de medio de contraste. 0.00 68.27 105.82 165.08 257.53 404.32 659.04 790.85 400-02 Abdomen 2 posiciones 0.00 22.87 35.45 55.31 86.28 135.46 220.80 264.96 400-03 Abdomen 2 posiciones (niño) 0.00 17.55 27.21 42.44 66.21 103.95 169.44 203.33 400-04 Abdomen agudo 2 posiciones c/tórax 0.00 30.73 47.63 74.30 115.92 181.99 296.64 355.97 400-05 Abdomen agudo niño 0.00 25.96 40.23 62.76 97.91 153.72 250.56 300.67 400-06 Abdomen simple 0.00 17.11 26.51 41.36 64.52 101.30 165.12 198.14 400-07 Abdomen simple niños 0.00 12.98 20.12 31.38 48.95 76.86 125.28 150.34 400-08 Agujeros ópticos 0.00 34.56 53.57 83.56 130.36 204.66 333.60 400.32 400-09 Ambas manos 0.00 18.80 29.13 45.45 70.90 111.31 181.44 217.73 400-10 Ambas muñecas 0.00 18.80 29.13 45.45 70.90 111.31 181.44 217.73 400-11 Ambas piernas 0.00 23.92 37.07 57.83 90.22 141.64 230.88 277.06 400-12 Ambas rodillas 0.00 21.83 33.84 52.78 82.34 129.28 210.72 252.86 400-13 Ambos calcáneos laterales 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59 400-14 Ambos codos 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59 400-15 Ambos fémures adulto 0.00 39.93 61.89 96.55 150.62 236.47 385.44 462.53 400-16 Ambos fémures niños 0.00 25.51 39.54 61.68 96.22 151.07 246.24 295.49 400-17 Ambos pies 0.00 19.09 29.60 46.17 72.03 113.08 184.32 221.18 400-18 Ambos tobillos 0.00 16.01 24.82 38.72 60.40 94.82 154.56 185.47 400-19 Antebrazo 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59 400-20 Aortografía translumbar y periférica * 0.00 148.78 230.60 359.74 561.20 881.08 1,436.16 1,723.39 400-21 Aortograma abdominal * 0.00 132.42 205.25 320.18 499.49 784.20 1,278.24 1,533.89 400-22 Apófisis mastoideas ambas 0.00 25.96 40.23 62.76 97.91 153.72 250.56 300.67 400-23 Arco aórtico * 0.00 136.49 211.57 330.04 514.87 808.34 1,317.60 1,581.12 400-24 Arco cigomático * 0.00 22.87 35.45 55.31 86.28 135.46 220.80 264.96 400-25 Art. temporo mandibulares (ambos lados) 0.00 28.00 43.39 67.69 105.60 165.79 270.24 324.29 400-26 Arteriografía bronquial * 0.00 136.49 211.57 330.04 514.87 808.34 1,317.60 1,581.12 400-27 Arteriografía c/embolización * 0.00 155.29 240.70 375.49 585.77 919.66 1,499.04 1,798.85 400-28 Arteriografía carótida 3 vasos (Panang.) * 0.00 322.17 499.36 779.00 1,215.24 1,907.93 3,109.92 3,731.90 400-29 Arteriografía carotidea * 0.00 140.62 217.96 340.02 530.44 832.79 1,357.44 1,628.93 400-30 Arteriografía carotidea 2 vasos * 0.00 215.01 333.27 519.89 811.04 1,273.33 2,075.52 2,490.62 400-31 Arteriografía de miembros * 0.00 108.15 167.63 261.51 407.96 640.49 1,044.00 1,252.80 400-32 Arteriografía de un miembro * 0.00 65.39 101.35 158.11 246.65 387.24 631.20 757.44 400-33 Arteriografía del tronco celiaco * 0.00 108.15 167.63 261.51 407.96 640.49 1,044.00 1,252.80 400-34 Arteriografía femoral por lado * 0.00 90.10 139.66 217.87 339.87 533.60 869.76 1,043.71 400-35 Arteriografía hepática * 0.00 157.68 244.40 381.26 594.77 933.79 1,522.08 1,826.50 400-36 Arteriografía mesentérica * 0.00 108.15 167.63 261.51 407.96 640.49 1,044.00 1,252.80 400-37 Arteriografía perif. miembro inferior bilateral * 0.00 157.68 244.40 381.26 594.77 933.79 1,522.08 1,826.50 400-38 Arteriografía perif. miembro inferior unilateral * 0.00 99.00 153.45 239.39 373.44 586.31 955.68 1,146.82 400-39 Arteriografía perif. miembro superior bilateral * 0.00 157.68 244.40 381.26 594.77 933.79 1,522.08 1,826.50 400-40 Arteriografía perif. miembro superior unilateral * 0.00 99.00 153.45 239.38 373.43 586.29 955.65 1,146.78 400-41 Arteriografía perif. por punción unilateral * 0.00 99.00 153.45 239.39 373.44 586.31 955.68 1,146.82 400-42 Arteriografía renal bilateral por Seldinger * 0.00 123.72 191.76 299.14 466.66 732.66 1,194.24 1,433.09 400-43 Arteriografía renal bilateral y aortog. * 0.00 107.85 167.17 260.79 406.83 638.72 1,041.12 1,249.34 400-44 Arteriografía renal con aortografía * 0.00 145.40 225.36 351.57 548.44 861.06 1,403.52 1,684.22 400-45 Arteriografía renal unilateral por Seldinger * 0.00 157.68 244.40 381.26 594.77 933.79 1,522.08 1,826.50 400-46 Articulación acromio clavicular 0.00 21.83 33.84 52.78 82.34 129.28 210.72 252.86 400-47 Articulación esterno-clavicular 0.00 21.83 33.84 52.78 82.34 129.28 210.72 252.86 400-48 Articulaciones sacro ilíacas oblicuas 0.00 21.83 33.84 52.78 82.34 129.28 210.72 252.86 400-49 Artrografía 0.00 53.26 82.55 128.77 200.88 315.39 514.08 616.90 400-50 Axial de rótula (1 posición) 0.00 17.11 26.51 41.36 64.52 101.30 165.12 198.14 400-51 Axial de rótula (30-60-90 grados) 0.00 22.87 35.45 55.31 86.28 135.46 220.80 264.96 400-52 Biopsia guiada por U.S ó Fluorosc. * 0.00 31.38 48.63 75.87 118.35 185.82 302.88 363.46 400-53 Biopsia próstata * 0.00 47.79 74.07 115.55 180.25 282.99 461.28 553.54 400-54 Brazo 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59 400-55 Broncografía 0.00 100.99 156.54 244.20 380.95 598.09 974.88 1,169.86 400-56 Cadera (fractura) 0.00 18.80 29.13 45.45 70.90 111.31 181.44 217.73 400-57 Cadera 3 posiciones niños 0.00 20.49 31.75 49.54 77.28 121.33 197.76 237.31




Cuotas (pesos)




400-58 Cadera A.P. y oblicua 0.00 18.80 29.13 45.45 70.90 111.31 181.44 217.73

400-59 Cadera niños (2 vistas) 0.00 17.11 26.51 41.36 64.52 101.30 165.12 198.14

400-60 Cadera simple niños 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59

400-61 Calcáneo lateral y axial (un solo lado) 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59

400-62 Calcáneos ambos (solo laterales) 0.00 16.01 24.82 38.72 60.40 94.82 154.56 185.47

400-63 Cara y Cuello lateral 0.00 10.89 16.88 26.33 41.08 64.49 105.12 126.14

400-64 Ciego y apéndice 0.00 29.69 46.01 71.78 111.98 175.80 286.56 343.87

400-65 Cistografía (retrógrada o miccional) 0.00 39.23 60.81 94.87 147.99 232.34 378.72 454.46

400-66 Cistografía c/cadena 0.00 49.48 76.69 119.63 186.63 293.01 477.60 573.12

400-67 Clavícula 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59

400-68 Codo 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59

400-69 Colangiografía endovenosa 0.00 67.13 104.05 162.32 253.21 397.55 648.00 777.60

400-70 Colangiografía percutanea * 0.00 87.37 135.42 211.25 329.55 517.40 843.36 1,012.03

400-71 Colangiografía por sonda en T * 0.00 39.23 60.81 94.87 147.99 232.34 378.72 454.46

400-72 Colangiografía retrógrada * 0.00 43.06 66.75 104.12 162.43 255.02 415.68 498.82

400-73 Colangiografía retrógrada endoscópica * 0.00 116.06 179.89 280.63 437.78 687.31 1,120.32 1,344.38

400-74 Colangiografía transoperatoria 0.00 27.30 42.31 66.01 102.97 161.67 263.52 316.22

400-75 Colarteriografía percutánea * 0.00 135.15 209.49 326.80 509.80 800.39 1,304.64 1,565.57

400-76 Colocación de drenaje biliar o renal 0.00 102.38 158.69 247.56 386.20 606.33 988.32 1,185.98

400-77 Colon por enema adultos 0.00 41.32 64.05 99.91 155.87 244.71 398.88 478.66

400-78 Colon por enema doble contraste 0.00 47.24 73.22 114.22 178.19 279.75 456.00 547.20

400-79 Colon por enema niños 0.00 41.32 64.05 99.91 155.87 244.71 398.88 478.66

400-80 Columna cervical AP y lateral 0.00 21.83 33.84 52.78 82.34 129.28 210.72 252.86

400-81 Columna cervical AP y lat. oblic.,flexión y extenc 0.00 23.22 35.99 56.15 87.59 137.52 224.16 268.99

400-82 Columna cervical c/oblicuas 0.00 29.04 45.01 70.22 109.54 171.98 280.32 336.38

400-83 Columna dorsal 0.00 21.83 33.84 52.78 82.34 129.28 210.72 252.86

400-84 Columna dorso-lumbar AP 0.00 21.83 33.84 52.78 82.34 129.28 210.72 252.86

400-85 Columna dorso-lumbar AP y lateral 0.00 27.30 42.31 66.01 102.97 161.67 263.52 316.22

400-86 Columna lumbar 0.00 25.96 40.23 62.76 97.91 153.72 250.56 300.67

400-87 Columna lumbar c/oblicuas 0.00 30.03 46.55 72.62 113.29 177.87 289.92 347.90

400-88 Columna vert. escoliosis 1 placa 0.00 15.27 23.66 36.91 57.58 90.40 147.36 176.83

400-89 Columna vert. escoliosis 2 placas 0.00 25.96 40.23 62.76 97.91 153.72 250.56 300.67



400-92 Contenido uterino (2) 0.00 21.83 33.84 52.78 82.34 129.28 210.72 252.86

400-93 Contenido uterino pelvimetría ó cefalopelvimetría 0.00 28.64 44.39 69.26 108.04 169.62 276.48 331.78

400-94 Cráneo AP y lateral 0.00 21.83 33.84 52.78 82.34 129.28 210.72 252.86

400-95 Cráneo c/incidencia de Hirtz 0.00 25.96 40.23 62.76 97.91 153.72 250.56 300.67

400-96 Cráneo con Stenvers 0.00 28.00 43.39 67.69 105.60 165.79 270.24 324.29

400-97 Cráneo en 2 posiciones 0.00 21.83 33.84 52.78 82.34 129.28 210.72 252.86

400-98 Cráneo en 3 posiciones 0.00 22.87 35.45 55.31 86.28 135.46 220.80 264.96

400-99 Cráneo lateral 0.00 13.28 20.58 32.10 50.08 78.63 128.16 153.79

400-100 Cráneo traumático 0.00 25.96 40.23 62.76 97.91 153.72 250.56 300.67

400-101 Cráneo y senos perinasales 0.00 28.00 43.39 67.69 105.60 165.79 270.24 324.29

400-102 Cuello partes blandas (1placa) 0.00 12.98 20.12 31.38 48.95 76.86 125.28 150.34

400-103 Deferentografía 0.00 43.31 67.13 104.72 163.37 256.49 418.08 501.70

400-104 Dinámicas de Col. lumbar flexión ant. y post. 0.00 25.96 40.23 62.76 97.91 153.72 250.56 300.67

400-105 Drenaje de absceso o colección 0.00 102.38 158.69 247.56 386.20 606.33 988.32 1,185.98

400-106 Edad ósea radiológica 0.00 18.45 28.59 44.61 69.59 109.25 178.08 213.70

400-107 Escápula 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59

400-108 Esclerosis venosa 0.00 77.17 119.62 186.60 291.10 457.03 744.96 893.95

400-109 Esófago cervical 0.00 25.96 40.23 62.76 97.91 153.72 250.56 300.67

400-110 Esófago toráxico (esofagograma) 0.00 25.96 40.23 62.76 97.91 153.72 250.56 300.67

400-111 Esofagograma infantil 0.00 14.02 21.73 33.91 52.89 83.04 135.36 162.43

400-112 Esplenoportografía * 0.00 114.02 176.73 275.70 430.09 675.24 1,100.64 1,320.77

400-113 Esternón 0.00 21.83 33.84 52.78 82.34 129.28 210.72 252.86

400-114 Fémur 0.00 25.96 40.23 62.76 97.91 153.72 250.56 300.67

400-115 Fémur niños 0.00 17.11 26.51 41.36 64.52 101.30 165.12 198.14

400-116 Fistulografía 0.00 30.03 46.55 72.62 113.29 177.87 289.92 347.90

400-117 Flebografía de miembros * 0.00 72.35 112.14 174.94 272.91 428.47 698.40 838.08

400-118 Flebografía de un miembro * 0.00 49.48 76.69 119.63 186.63 293.01 477.60 573.12

400-119 Flebografía unilat. miembros inferiores (pierna) * 0.00 44.65 69.21 107.97 168.43 264.44 431.04 517.25

400-120 Fluoroscopía 0.00 27.30 42.31 66.01 102.97 161.67 263.52 316.22

400-121 Galactografía 0.00 54.20 84.01 131.06 204.45 320.98 523.20 627.84

400-122 Histerosalpingografía 0.00 44.01 68.21 106.41 166.00 260.61 424.80 509.76

400-123 Hombro AP 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59




Cuotas (pesos)




400-124 Hombro AP y lateral 0.00 20.49 31.75 49.54 77.28 121.33 197.76 237.31

400-125 Hombro rotación externa o interna 0.00 22.87 35.45 55.31 86.28 135.46 220.80 264.96

400-126 Hombro rotación interna y externa 0.00 22.87 35.45 55.31 86.28 135.46 220.80 264.96

400-127 Huesos de la cara 0.00 24.91 38.61 60.24 93.97 147.53 240.48 288.58

400-128 Huesos de la nariz y perfilograma 0.00 21.83 33.84 52.78 82.34 129.28 210.72 252.86

400-129 Huesos largos 0.00 39.93 61.89 96.55 150.62 236.47 385.44 462.53

400-130 Investigación esquelética 0.00 54.60 84.63 132.02 205.95 323.34 527.04 632.45

400-131 Investigación esquelética c/tórax 0.00 66.23 102.66 160.15 249.84 392.25 639.36 767.23

400-132 Lateral de cráneo (ortodoncia) 0.00 13.28 20.58 32.10 50.08 78.63 128.16 153.79

400-133 Lateral de cuello 0.00 12.98 20.12 31.38 48.95 76.86 125.28 150.34

400-134 Mamografía 0.00 34.16 52.95 82.60 128.86 202.31 329.76 395.71

400-135 Mano 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59

400-136 Mastoides (Stenvers) 0.00 22.87 35.45 55.31 86.28 135.46 220.80 264.96

400-137 Mastoides comparativas 1 por lado c/una 0.00 14.37 22.27 34.75 54.21 85.10 138.72 166.46

400-138 Maxilar inferior 0.00 24.91 38.61 60.24 93.97 147.53 240.48 288.58

400-139 Mecánica de deglución (1 placa) 0.00 10.24 15.88 24.77 38.64 60.66 98.88 118.66

400-140 Medición radiológica miembros inferiores 0.00 18.80 29.13 45.45 70.90 111.31 181.44 217.73

400-141 Mielografía cervical 0.00 143.36 222.20 346.64 540.75 848.98 1,383.84 1,660.61

400-142 Mielografía cérvico dorsal 0.00 143.36 222.20 346.64 540.75 848.98 1,383.84 1,660.61

400-143 Mielografía completa 0.00 144.70 224.28 349.88 545.82 856.93 1,396.80 1,676.16

400-144 Mielografía dorsal 0.00 143.36 222.20 346.64 540.75 848.98 1,383.84 1,660.61

400-145 Mielografía dorsolumbar * 0.00 143.36 222.20 346.64 540.75 848.98 1,383.84 1,660.61

400-146 Mielografía lumbar * 0.00 143.36 222.20 346.64 540.75 848.98 1,383.84 1,660.61

400-147 Muñeca 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59

400-148 Nefrostomía percutánea * 0.00 84.63 131.18 204.64 319.24 501.20 816.96 980.35

400-149 Omóplato 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59

400-150 Orbitas 0.00 22.87 35.45 55.31 86.28 135.46 220.80 264.96

400-151 Orbitas con agujeros ópticos 0.00 18.80 29.13 45.45 70.90 111.31 181.44 217.73

400-152 Pelvimetría 0.00 21.83 33.84 52.78 82.34 129.28 210.72 252.86

400-153 Pelvis 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59

400-154 Pelvis AP y rana (2 posiciones) 0.00 21.83 33.84 52.78 82.34 129.28 210.72 252.86

400-155 Pelvis AP niños 0.00 12.98 20.12 31.38 48.95 76.86 125.28 150.34

400-156 Pie 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59

400-157 Pielografía ascendente o retrógrada 0.00 55.00 85.24 132.98 207.45 325.69 530.88 637.06

400-158 Pielografía descendente con sonda de nefrostom 0.00 53.80 83.39 130.09 202.95 318.63 519.36 623.23

400-159 Pierna 0.00 19.79 30.68 47.85 74.65 117.20 191.04 229.25

400-160 Pierna (niños) 0.00 19.09 29.60 46.17 72.03 113.08 184.32 221.18

400-161 Pies AP y lat. (con apoyo y en reposo) 0.00 25.96 40.23 62.76 97.91 153.72 250.56 300.67

400-162 Rodilla 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59

400-163 Sacrocoxis 0.00 21.83 33.84 52.78 82.34 129.28 210.72 252.86

400-164 Senos perinasales 0.00 25.96 40.23 62.76 97.91 153.72 250.56 300.67

400-165 Senos perinasales y cavum 0.00 28.00 43.39 67.69 105.60 165.79 270.24 324.29

400-166 Serie cardíaca adultos 0.00 30.03 46.55 72.62 113.29 177.87 289.92 347.90

400-167 Serie cardíaca niños 0.00 25.31 39.23 61.20 95.47 149.89 244.32 293.18

400-168 Serie gastroduodenal adultos 0.00 54.20 84.01 131.06 204.45 320.98 523.20 627.84

400-169 Serie gastroduodenal niños 0.00 39.23 60.81 94.87 147.99 232.34 378.72 454.46

400-170 Serie ósea metastásica 0.00 54.60 84.63 132.02 205.95 323.34 527.04 632.45

400-171 Serie ósea y tórax 0.00 66.23 102.66 160.15 249.84 392.25 639.36 767.23

400-172 Sialografía (un lado) 0.00 43.31 67.13 104.72 163.37 256.49 418.08 501.70

400-173 Stenvers 0.00 22.87 35.45 55.31 86.28 135.46 220.80 264.96

400-174 Tangencial rótula (1) 0.00 15.02 23.28 36.31 56.64 88.93 144.96 173.95

400-175 Tangenciales 30-60-90 0.00 19.79 30.68 47.85 74.65 117.20 191.04 229.25

400-176 Tangenciales rótula (2) 0.00 17.11 26.51 41.36 64.52 101.30 165.12 198.14

400-177 Tiempo de fluoroscopía 0.00 27.30 42.31 66.01 102.97 161.67 263.52 316.22

400-178 Tobillo 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59

400-179 Tórax (pulmones) adulto 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59

400-180 Tórax (pulmones) niños 0.00 12.98 20.12 31.38 48.95 76.86 125.28 150.34

400-181 Torax PA (una placa) 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59

400-182 Tórax adultos PA y lateral 0.00 21.83 33.84 52.78 82.34 129.28 210.72 252.86

400-183 Tórax niños PA y lateral 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59

400-184 Tórax óseo (ambos lados) 0.00 28.00 43.39 67.69 105.60 165.79 270.24 324.29

400-185 Tórax óseo (un lado) 0.00 21.83 33.84 52.78 82.34 129.28 210.72 252.86

400-186 Tórax óseo niños (ambos lados) 0.00 25.96 40.23 62.76 97.91 153.72 250.56 300.67

400-187 Tórax óseo niños (un lado) 0.00 17.11 26.51 41.36 64.52 101.30 165.12 198.14

400-188 Tracto urinario a vacuo adulto 0.00 15.76 24.43 38.11 59.46 93.35 152.16 182.59

400-189 Tracto urinario a vacuo niños 0.00 12.98 20.12 31.38 48.95 76.86 125.28 150.34




Cuotas (pesos)




400-190 Tránsito intestinal 0.00 54.20 84.01 131.06 204.45 320.98 523.20 627.84

400-191 Urecistografía miccional adultos 0.00 56.69 87.86 137.07 213.83 335.71 547.20 656.64

400-192 Uretrocistografía miccional niños 0.00 49.48 76.69 119.63 186.63 293.01 477.60 573.12

400-193 Uretrografía retr. ascendente 0.00 55.00 85.24 132.98 207.45 325.69 530.88 637.06

400-194 Uretrografía retrógrada o miccional 0.00 50.17 77.77 121.32 189.25 297.13 484.32 581.18

400-195 Urografía de Arata 0.00 55.00 85.24 132.98 207.45 325.69 530.88 637.06

400-196 Urografía de Maxwell 0.00 55.00 85.24 132.98 207.45 325.69 530.88 637.06

400-197 Urografía endovenosa adulto 0.00 49.48 76.69 119.63 186.63 293.01 477.60 573.12

400-198 Urografía endovenosa niños 0.00 45.05 69.83 108.93 169.93 266.80 434.88 521.86

400-199 Urografía ret. o miccional 0.00 47.09 72.99 113.86 177.62 278.87 454.56 545.47

400-200 Urografía retrógrada adulto 0.00 55.00 85.24 132.98 207.45 325.69 530.88 637.06

400-201 Urografía retrógrada niños 0.00 45.05 69.83 108.93 169.93 266.80 434.88 521.86

400-202 USG complemento de mamografía 0.00 12.28 19.04 29.70 46.33 72.74 118.56 142.27

400-203 Waters 0.00 12.98 20.12 31.38 48.95 76.86 125.28 150.34

400-204 Waters y lateral de cuello 0.00 17.11 26.51 41.36 64.52 101.30 165.12 198.14

410-00 LEUCEMIA

Prueba de determinación de Inmunofenotipo de

410-01 Leucemia 0.00 445.45 690.45 1,077.10 1,680.28 2,638.04 4,300.00 5,160.00

DIRECCION ADMINISTRATIVA ANEXO VII Cuotas (pesos) · Nota: Los precios de los servicios y/o...

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